Unveiling the Silent Struggle: A Teen's Battle With Heart Failure Masking Takayasu Arteritis

We hereby report a 17-year-old adolescent who presented with heart failure with an underlying diagnosis of Takayasu arteritis. Her clinical complaints were intermittent fever, claudication pain in the left upper limb, New York Heart Association (NYHA) grade III dyspnea, and episodes of dizziness for the past two years. On examination, she was unconscious, had absent peripheral pulses, and had severe hypotension. Diagnostic investigations revealed anemia, deranged renal and liver functions, cardiomegaly on chest X-rays, and severe coarctation of the aorta on echocardiography. Further imaging with CT aortography highlighted extensive arterial wall thickening. Laboratory findings included elevated inflammatory markers and negative autoimmune and infectious markers, confirming the diagnosis of large vessel vasculitis (Takayasu arteritis) with heart failure with reduced ejection fraction (LVEF 20-25%) in NYHA class III. The patient was managed with a combination of antihypertensive medications, diuretics, and immunosuppressive therapy. Subsequent follow-up demonstrated improvement in heart failure symptoms and inflammatory markers. This case emphasizes the challenging diagnostic and therapeutic considerations in managing Takayasu arteritis with concurrent cardiovascular complications in the adolescent population.