Case Report
Volume 7 Issue 4 - 2020
A Rare Case of Non-Ischemic Dilated Cardiomyopathy Revealing a Takayasu Arteritis
Meryem Haboub*, H Tahri, S Serbout, I Tlohi, S Arous, MEG Benouna, L Azzouzi and R Habbal
Cardiology Department, University Hospital Ibn Rochd, Casablanca, Morocco
*Corresponding Author: Meryem Haboub, Cardiology Department, University Hospital Ibn Rochd, Casablanca, Morocco.
Received: March 11, 2020; Published: March 24, 2020




Abstract

Background: Takayasu arteritis is a rare, systemic, inflammatory large vessel arteritis of unknown aetiology. It predominantly involves the aorta and its major branch arteries. It commonly occurs in women younger than 50 years of age. It can affect the cardiovascular system and renovascular hypertension and aortic regurgitation are the most prevalent manifestations. Dilated cardiomyopathy is rare and commonly due to renal artery stenosis or coronary artery involvement, otherwise, it is extremely rare.

Case Presentation: We are reporting a case of a 37-year-old woman presenting to the Emergency Department with acute stage IV NYHA dyspnea and orthopnea. Symptoms and signs were suggestive of acute decompensated heart failure which was managed medically using IV furosemide and nitrates. Transthoracic echocardiogram revealed a dilated cardiomyopathy, LVEF at 28%. Coronary artery angiography showed a distal chronic complete obstruction of left anterior descending artery with a subocclusion of the origin of the first diagonal artery, lesions which are not explaining the cardiomyopathy. Duplex ultrasound did not find any renal artery stenosis but a severe left post-vertebral subclavian artery stenosis. Laboratory tests are showing increased inflammation, no arguments for connective tissue disease. Takayasu arteritis was confirmed using the American College of Rheumatology criteria and patient was prescribed corticosteroids and cyclophosphamide along with heart failure therapy. This attitude improved her symptoms and quality of life as well as survival.

Conclusion: It is important for cardiologists to think of Takayasu arteritis as a potential cause of non-ischemic dilated cardiomyopathy, especially in a young woman, as immunosuppressive therapy can improve symptoms and LV remodeling, prevent LV systolic function deterioration and reduce cardiovascular events.

 

Keywords: Takayasu Arteritis; Young Woman; Dilated Cardiomyopathy; Acute Decompensated Heart Failure; Inflammation

References

  1. Jennette JC., et al. “Nomenclature of systemic vasculitis. Proposal of an international consensus conference”. Arthritis and Rheumatology 37.2 (1994): 187-192. 
  2. Kerr GS., et al. “Takayasu arteritis”. Annals of Internal Medicine 120 (1994): 919-929. 
  3. Elefteriades JA., et al. “Diseases of the Aorta”. In: Fuster V, Walsh RA, Harrington RA, editors. Hurst’s the Heart. 13th edition. New York: The McGraw-Hill Companies, Inc. (2011): 2285-2286. 
  4. Md Faruque. “Takayasu Arteritis Involving Multiple Peripheral Arteries of a 37-year-old Female: A Case Report and Brief Overview”. Bangladesh Heart Journal 30.2 (2015). 
  5. Panja M., et al. “Cardiac involvement in non-specific aorto-arteritis”. International Journal of Cardiology 34.3 (1992): 289-295. 
  6. Jain S., et al. “Current status of Takayasu arteritis in India”. International Journal of Cardiology 54 (1996): S111-S116. 
  7. Mavrogeni S and Manoussakis MN. “Myocarditis and subclavian stenosis in Takayasu arteritis”. International Journal of Cardiology 148.2 (2011): 223-224. 
  8. Ghosh S., et al. “Dilated cardiomyopathy in nonspecific aortoarteritis”. Indian Heart Journal 51 (1999): 527-531. 
  9. Yadav MK. “Pulseless cardiomyopathy”. Journal of the Association of Physicians of India 54 (2006): 814-816. 
  10. William P Arend. “The American college of rheumatology 1990 criteria for the classification of Takayasu arteritis”. Arthritis and Rheumatism 33.8 (1990). 
  11. Hur JH., et al. “CT features of vasculitides based on the 2012 International Chapel Hill Consensus Conference revised classification”. Korean Journal of Radiology 18.5 (2017): 786-798. 
  12. Amano J and Suzuki A. “Coronary artery involvement in Takayasu's arteritis. Collective review and guideline for surgical treatment”. Journal of Thoracic and Cardiovascular Surgery 102 (1991): 554-560. 
  13. Nagata S. “Present state of autopsy cases of Takayasu’s arteritis (aortitis syndrome) in Japan”. Journal of Japanese College of Angiology 30 (1990): 1303-1308.
Citation: Meryem Haboub., et al. “A Rare Case of Non-Ischemic Dilated Cardiomyopathy Revealing a Takayasu Arteritis”. EC Cardiology 7.4 (2020): 32-35.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


June Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the June issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before July 06, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk