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| A PICTURE IS WORTH A THOUSAND WORDS |
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| Year : 2003 | Volume
: 4
| Issue : 3 | Page : 8 |
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Takayasu Disease
| Date of Web Publication | 22-Jun-2010 |
Correspondence Address:
 Source of Support: None, Conflict of Interest: None  | Check |
How to cite this article:
. Takayasu Disease. Heart Views 2003;4:8 |
A 26-year-old patient from Nepal was referred for echocardiography because of severe LVH by ECG, absent left radial pulse, weak left femoral pulse and hypotension of the left upper arm. BP recordings: Right upper arm = 139/63; left upper arm = 84/46; Right thigh 147/59; Left thigh = 153/56.
Suprasternal 2-dimensional echocardiography scan of the aorta [Figure 1]a shows narrowing of the caliber of the descending thoracic aorta beginning at the expected site of origin of the left subclavian artery (white arrow). Doppler color flow [Figure 1]b clearly shows severe coarctation (red arrows) 6 cm distal to the origin of the subclavian artery. No flow was demonstrated in the left subclavian artery. The maximum Doppler systolic pressure gradient across the coarctation was 90 mmHg. Other echocardiographic findings were LVH and left ventricular enlargement. Early phase MRA [Figure 2]a shows complete occlusion of the left subclavian artery (yellow arrow) and the left common carotid artery (white arrow) with marked stenosis (red arrows) of the descending aorta 6.5 cm distal to the origin of the left subclavian artery. The right innominate artery appears normal. Delayed phase MRA [Figure 2]b reveals filling of the left vertebral artery (arrow) and reverse flow from above (seen in phase image). Arch aortogram [Figure 3] shows aneurysmal dilatation of the distal innominate artery (thick white arrow) proximal to the site of origin of the right vertebral artery (orange arrow) and the right subclavian artery (red arrow) with multiple collaterals (thin white arrows) from surrounding vessels).
Abbreviations: DAo = descending aorta; IA = innominate aretery; AAo = ascending aorta.
From the Echocardiography Laboratory, Department of Cardiology & Cardiovascular Surgery and Department of Radiology, Hamad Medical Corporation, Doha, Qatar
[Figure 1], [Figure 2], [Figure 3]
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