Recently, humanity has completely revised its attitude to various kinds of diseases. Many people today prefer a he althy lifestyle, try to eat right, gradually give up bad habits. Such measures act as the prevention of many ailments. Unfortunately, even the right lifestyle does not 100% guarantee that a person will not be overtaken by this or that disease.
General information
Takayasu's disease is a rather serious inflammation of a chronic nature, which occurs in the area of large blood vessels. Their main function is to carry blood away from the heart. Of course, the improper functioning of this organ affects the entire body. Otherwise, this ailment is called the disease of the absence of a pulse, Takayasu's syndrome, or nonspecific aortoarteritis.
With progressive inflammation of the aorta and its branches, the inner surface of the vessels themselves is gradually damaged. As a result, there is a thickening of their central shell. Destruction of the middle smooth muscle layer is observed. in the lumen of the aortagranulomas appear, consisting mainly of giant cells. All these processes cause protrusion and expansion of the blood vessel itself, an aneurysm is formed. In the case of further progression of the disease, the so-called elastic fibers die off. As a result, blood flow is gradually disturbed, which leads to ischemia of internal organs and tissues. Then microthrombi and atherosclerotic plaques form on the damaged walls.
Takayasu's disease is predominantly diagnosed in girls and women between the ages of 15 and approximately 25 years. In medicine, cases of the manifestation of the disease in male patients are also known.
The first symptoms usually appear between the ages of 8-12. It is important to note that this disease is predominantly common in South America and Southeast Asia, but today, cases of Takayasu's syndrome are also recorded in more remote regions.
A bit of history
In 1908, an ophthalmologist from the Land of the Rising Sun M. Takayasu spoke about pathological changes in the vessels of the retina, discovered during the next examination of a young woman. In the same year, other specialists from Japan noted similar deformations of the fundus in their patients, which was combined with the absence of pulsation of the so-called radial artery. It is noteworthy that the very term "Takayasu's disease" began to be actively used in medicine only in 1952.
Main reasons
The etiological agent of this disease is currently unknown. Experts have identified a link between the disease and the well-knownstreptococcal infection, the role of microbacterium tuberculosis is actively discussed.
Today, scientists believe that the imbalance of the so-called cellular immunity is of paramount importance in the formation of autoimmune disorders. It is noteworthy that in the blood of patients, as a rule, there is an increase in the content of CD4+ T-lymphocytes and a decrease in the number of CD8+ T-lymphocytes. Also, experts diagnose an increase in the number of circulating immune complexes, an increase in the activity of elastase and a special cathepsin G.
How is non-specific aortoarteritis classified?
Takayasu's disease, based on the anatomy of the lesion, is conditionally divided into several types.
- The first type. The aortic arch and all branches extending from it are affected.
- Second type. The abdominal and thoracic aorta are affected.
- Third type. The aortic arch is affected, along with the thoracic and abdominal sections.
- The fourth type. The disease involves the pulmonary artery.
Symptoms
First of all, patients begin to complain of pain in the arms, weakness, discomfort in the chest and neck. As a result, there is a symptomatology characteristic of neurological disorders. For example, distracted attention, decreased performance, memory problems.
When the disease is associated with the optic nerve, patients experience a sharp decrease in vision or even blindness (usually only in one eye).
Due to pathological changes in the arterial vessels, the so-calledaortic insufficiency. This problem entails myocardial infarction and disturbances in the coronary circulation.
With minor changes directly in the abdominal aorta itself, blood circulation in the legs is significantly worsened, while walking, patients experience discomfort and pain.
When the kidney artery is damaged, erythrocytes are found in the urine during the next examination. In the future, the likelihood of developing renal artery thrombosis is very high.
In case of involvement in the inflammatory process of the pulmonary artery, patients develop shortness of breath, pain in the chest.
In medicine today there are two stages of this disease: acute and chronic. It is important to note that only a doctor is able to accurately determine the course of the disease. Clinical signs of the acute form may be atypical, so it can be very difficult to make a timely and correct diagnosis. The thing is that the same manifestations are possible not only with such an ailment as Takayasu's disease.
Symptoms of an acute period:
- weight loss;
- excessive sweating;
- slight increase in body temperature;
- fatigue;
- rheumatic joint pains.
The chronic stage, as a rule, develops 6 years after the onset of the disease. It is characterized by different clinical features.
Takayasu's disease manifests itself in the form of frequent headaches, impaired coordination, discomfort along large joints, chronic muscle weakness.
Diagnosis
Only a qualified specialist can confirm the presence of this disease if the patient has at least three of the following symptoms:
- disappearance of the pulse in the arms;
- age over 40;
- between blood pressure on the upper limbs the difference is not less than 10 mm Hg. Art.;
- murmurs in the aorta;
- persistent increase in blood pressure;
- Continued increase in ESR.
All of the above signs are usually indicative of Takayasu's disease. Symptoms may be slightly different and vary from case to case.
It is important to note that the doctor must prescribe an additional examination of the patient's body without fail. It implies a biochemical / general blood test, which allows you to determine the slightest deviations from the norm, characteristic of this disease. In addition, angiography with the introduction of a contrast agent will be required. This is a special x-ray study of blood vessels, which allows you to determine the places of narrowing of the arteries. Echocardiography makes it possible to evaluate the work of the heart. No less important is the ultrasound examination of the vessels. Through ultrasound, the doctor receives a complete picture of the state of the coronary vessels and blood flow velocity. All of the above diagnostic research methods can confirm the presence of such a problem as Takayasu's aortoarteritis.
What should be the therapy?
Considering the factthat the disease predominantly progresses in adolescence, treatment can be somewhat difficult. Definitely requires a qualified integrated approach and compliance with certain preventive rules. In particularly difficult cases, surgical intervention may be required.
Takayasu's treatment involves the use of drugs. To stabilize blood pressure, as a rule, B-blockers and the so-called calcium channel blockers are prescribed. To eliminate possible blood clots, patients are recommended to take anticoagulants (Heparin and others). Therapy for this disease also includes the use of vasodilators and corticosteroids (Prednisolone, etc.). It is important to note that the latter significantly reduce the body's autoimmune response.
How else can Takayasu's disease be overcome? Treatment of this disease today is possible through the so-called extracorporeal hemocorrection. This is a very complicated procedure. It implies the allocation of special pathological components of the blood, which directly provoke the development of the disease. These elements are processed outside the patient's body.
Surgical treatment
According to experts, conservative therapy does not always allow to overcome Takayasu's syndrome. Symptoms can be stopped only for a while. Of course, such measures are not enough, a relapse may occur very soon. That is why inin some cases, doctors strongly recommend surgery, which fully restores the patency of the vascular bed.
Main indications for surgery:
- hypertension due to vasorenal syndrome;
- obstruction of the aorta;
- danger of heart ischemia.
If we talk about ongoing surgical procedures, they are most often represented by resection of the pathological segment of the aorta, bypass grafting and endarterectomy. With a qualified approach, the patient almost forever forgets what Takayasu's syndrome is.
Prevention
As you know, any pathology can be prevented, and this disease is no exception. Preventive measures imply the timely treatment of all ailments of an infectious and viral nature (pharyngitis, tonsillitis, pyelonephritis, etc.). According to experts, the chronic course of these diseases becomes a favorable basis for the development of Takayasu's syndrome, so patients are at risk.
It is extremely important to strengthen immunity throughout the year. For these purposes, experts recommend taking multivitamin complexes, eating right, playing sports.
Forecast
Adequate and timely treatment significantly reduces the risk of death. Moreover, in 90% of patients, competent therapy prolongs life by approximately 15 years.
When it comes to complications, the most common cause of death is stroke (50%) and myocardial infarction(25%).
Conclusion
Patients who have been diagnosed with Takayasu's syndrome should understand that this problem requires long-term treatment with the obligatory observance of all doctor's recommendations. Otherwise, the risk of cardiovascular complications increases several times.
In order for the therapy to be as effective as possible, all patients, without exception, are recommended to undergo regular examinations and take a set of tests.
Unfortunately, it is not possible to completely get rid of the disease. However, the use of drugs allows you to transfer the disease to the stage of remission, which allows patients to enjoy a normal life, not experience discomfort and not remember such a problem as Takayasu's disease. Photos of patients clearly prove this statement.
The success of therapy largely depends on the activity of the pathological process and the presence of complications. In addition, the sooner a correct diagnosis is made, the more optimistic the prognosis will be. If you believe the experts, then it is possible and simply necessary to fight this disease.
