Recently, mankind has completely revised its attitude to various diseases. Many people today prefer a healthy lifestyle, try to eat right, gradually abandon bad habits. Such measures act as the prevention of many ailments. Unfortunately, even a correct lifestyle does not 100% guarantee that a person will not be overtaken by a particular disease.
general information
Takayasu's disease is a rather serious inflammation of a chronic nature, which is noted in the region of large blood vessels. Their main function is to transfer blood from the heart. Of course, the malfunction of this body affects the whole body. Otherwise, this ailment is called a pulseless disease, Takayasu 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, a thickening of their central membrane occurs. The destruction of the middle smooth muscle layer is observed. Granulomas consist of predominantly giant cells in the aortic lumen. 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. As a result, blood flow is gradually disturbed, which entails ischemia of internal organs and tissues. Then, microthrombi and atherosclerotic plaques form on the damaged walls.
Takayasu disease is primarily diagnosed in girls and women aged 15 to about 25 years. In medicine, cases of manifestation of the disease in male patients are also known.
The first symptoms, as a rule, appear at the age of 8-12 years. It is important to note that this disease is predominantly prevalent in countries of South America and Southeast Asia, however, today, cases of Takayasu 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 found during the next examination of one young woman. In the same year, other specialists from Japan noted similar fundus deformities in their patients, which was combined with the absence of pulsation of the so-called radial artery. It is noteworthy that the term "Takayasu disease" itself began to be actively used in medicine only in 1952.
Main reasons
The etiological agent of this disease is currently unknown. Experts have identified the connection of the disease with all known streptococcal infection, the role of tuberculosis microbacteria is actively discussed.
Today, scientists believe that the imbalance of the so-called cellular immunity is of primary 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 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.
- First type. The aortic arch and all branches extending from it are affected.
- The second type. The abdominal and thoracic aorta are affected.
- The third type. The aortic arch along with the thoracic and abdominal regions is affected.
- The fourth type. The pulmonary artery is involved in the disease.
Symptoms
First of all, patients begin to complain about the appearance of pain in the hands, 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.
If 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-called aortic insufficiency develops. This problem entails myocardial infarction and disturbances in coronary circulation.
With minor changes directly in the abdominal aorta itself, blood circulation in the leg area significantly worsens, while walking patients experience discomfort and pain.
With damage to the arteries of the kidneys in the urine, the next study reveals red blood cells. In the future, the likelihood of developing thrombosis of the renal artery is very high.
In case of involvement in the inflammatory process of the pulmonary artery, patients develop shortness of breath, pain in the chest area.
In medicine, two stages of this disease are distinguished today: acute and chronic. It is important to note that only the doctor is able to accurately determine the course of the disease. Clinical signs of an acute form can be atypical, so it can be very difficult to make a diagnosis in a timely manner and correctly. The thing is that the same manifestations are possible not only with such an ailment as Takayasu's disease.
Symptoms of the acute period:
- weight loss;
- increased sweating;
- a slight increase in body temperature;
- fatigue
- rheumatic joint pain.
The chronic stage, as a rule, develops 6 years after the onset of the disease. It is characterized by other clinical signs.
Takayasu's disease manifests itself in the form of frequent headaches, impaired coordination, discomfort along the large joints, chronic muscle weakness.
Diagnostics
The presence of this disease can only be confirmed by a qualified specialist if the patient has at least three of the following symptoms:
- the disappearance of the pulse in the arms;
- age over 40 years;
- between blood pressure on the upper extremities, the difference is not less than 10 mm RT. st .;
- murmur in the aorta;
- persistent increase in blood pressure;
- continuous increase in ESR.
All of the above symptoms usually indicate Takayasu's disease. Symptoms may vary slightly and vary in each individual case.
It is important to note that the doctor must prescribe an additional examination of the patient’s body . It implies a biochemical / general blood test, which allows you to determine the slightest deviations from the norm, characteristic of this ailment. In addition, angiography with the introduction of a contrast agent will be required. This is a special x-ray examination of blood vessels, which allows to determine the narrowing of the arteries. Echocardiography makes it possible to evaluate the work of the heart. No less important is the ultrasound examination of blood vessels. Through ultrasound, the doctor gets a complete picture of the condition 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 aortoarteritis.
What should be the therapy?
If we take into account the fact that the disease mainly progresses in adolescence, treatment may be somewhat difficult. Definitely requires a qualified integrated approach and compliance with some preventive rules. In particularly difficult cases, surgical intervention may be required.
Takayasu treatment implies 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 advised to take anticoagulants (Heparin and others). Therapy of this disease also includes the use of vasodilator drugs and corticosteroids (the drug "Prednisolone", etc.). It is important to note that the latter significantly reduce the autoimmune response from the body.
How else can you overcome Takayasu's disease? Treatment of this ailment 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. The processing of these elements occurs outside the patient's body.
Surgery
According to experts, conservative therapy does not always allow overcoming Takayasu syndrome. Symptoms manage to stop only for a while. Of course, such measures are not enough, a relapse may come very soon. That is why in some cases, doctors strongly recommend surgical intervention, which fully restores the patency of the vascular bed.
The main indications for the operation:
- hypertension on the background of vasorenal syndrome;
- aortic obstruction;
- the risk of cardiac 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 syndrome is.
Prevention
As you know, any pathology can be prevented, and this disease was no exception. Preventive measures include 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 syndrome, so patients are at risk.
It is extremely important to strengthen the immune system throughout the year. For these purposes, experts recommend taking multivitamin complexes, eating properly, 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.
As for complications, most often the main cause of death are strokes (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 the doctor's recommendations. Otherwise, the risk of cardiovascular complications increases several times.
In order for therapy to be as effective as possible, it is recommended that all patients, without exception, 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 ailment to the stage of remission, which allows patients to enjoy a normal life, not to feel discomfort and not recall a problem like 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 the correct diagnosis is made, the more optimistic the prognosis will be. If you believe the experts, then it is possible and simply necessary to deal with this ailment.