Takayasu arteritis (TA), a rare large-vessel vasculitis, primarily affects women of childbearing age, causing granulomatous inflammation in the aorta and its major branches. This inflammation can lead to stenosis, aneurysms, or occlusion, with the abdominal aorta, subclavian, and brachial arteries commonly involved. We present the case of a 26-year-old female with TA with a rare involvement of the superior mesenteric artery (SMA). The patient presented with progressive shortness of breath and exertional pain in the left upper limb, suggesting claudication. Echocardiography showed an ejection fraction of 45% and right ventricular systolic pressure of 65 mmHg. CT angiography (CTA) revealed diffuse involvement of the abdominal aorta with non-opacification of SMA, and other findings were consistent with TA type 5. The patient was successfully treated with methylprednisolone to induce remission, along with guideline-directed medical therapy for heart failure.
Keywords: aortic wall thickening; ct aortogram; large vessel vasculitis; narrowing of aorta; stenosed renal artery; superior mesenteric artery (sma); takayasu arteritis (tak); upper extremity claudication.
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