What are the symptoms of Takayasu arteritis?

Takayasu arteritis is a common clinical disease, which is particularly common in young women. There are many sites where Takayasu arteritis can occur, and the symptoms in different sites are also different. In addition, the type of disease needs to be considered. Different types of large arteritis have different symptoms and severity. When treating, the main focus is on prescribing the right medicine for the right disease. So what are the symptoms of large arteritis?

1. Brachiocephalic artery type

Stenosis and occlusion of the carotid artery, subclavian artery, and vertebral artery. It can cause varying degrees of cerebral ischemia, ranging from transient ischemic attack (TIA) to stroke, and may cause dizziness, vertigo, headache, memory loss, and vision loss. Severe cerebral ischemia may cause repeated syncope, convulsions, aphasia, hemiplegia, or coma. Upper limb ischemia may cause unilateral or bilateral upper limb weakness, coldness, soreness, numbness and even muscle atrophy. The carotid, radial, and brachial arteries may experience weakened or absent pulsations (pulseless sign), and about half of the patients can hear a grade 2 or higher systolic vascular murmur in the neck or supraclavicular area.

2. Thoracic and abdominal aorta type

Vascular inflammation affects the thoracic aorta, abdominal aorta, and even the entire aorta. Symptoms of hypertension in the head, neck, upper limbs and insufficient blood supply to the lower limbs. Such as headache, dizziness, palpitations, cold lower limbs, intermittent claudication, etc. The skin temperature of the lower limbs is low, and the pulse distal to the blockage is significantly weakened or absent. A systolic vascular murmur can be heard at the site of obstruction, and blood pressure in the upper limbs is often significantly elevated.

3. Aorto-renal artery type

The main affected areas are the aorta and renal arteries. Hypertension is an important clinical manifestation, especially the obvious increase in diastolic blood pressure, which manifests as dizziness and palpitations, and limb weakness, coldness, and intermittent claudication due to lower limb ischemia. When the difference in blood pressure between the patient's upper and lower limbs is >20 mmHg, it indicates aortic stenosis. In most patients, a high-pitched systolic murmur can be heard above the umbilicus.

4. Pulmonary artery-coronary artery type

It is not uncommon for lesions to involve the pulmonary arteries, which can be seen in unilateral or bilateral lobar or segmental arteries, and multiple lesions are present. Coronary artery involvement is rare, with the anterior descending artery opening or its proximal segment being narrowed or occluded. Palpitations and shortness of breath are more common but relatively mild. Once a coronary artery disease occurs, the consequences are serious. A systolic murmur can be heard in the pulmonary valve area, and the breath sounds are weakened on the side with severe pulmonary artery stenosis.

5. Extensive

It has the characteristics of the above two types, is a multiple lesion, and most patients have severe conditions.