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Beyond the Norm: Recognizing Uncommon Presentations of Large Vessel Vasculitis
Bishakha Swain1, Girija Sachdev2, Rohini Samant3
1Resident, Department of Rheumatology, P D Hinduja Hospital and Medical Research Centre, Mumbai, India, Orcid: https://orcid.org/0000-0003-0754-0248, Corresponding Author.
The Journal of the Association of Physicians of India
|September 16, 2025
Summary
Large vessel vasculitis (LVV), including Takayasu arteritis (TAK), can present with unusual symptoms. Early diagnosis is vital to prevent irreversible damage and improve patient outcomes, especially in primary care.
Area of Science:
- Cardiology
- Rheumatology
- Internal Medicine
Background:
- Large vessel vasculitis (LVV) affects the aorta and its branches, with Takayasu arteritis (TAK) being a recognized form.
- Typical TAK symptoms include limb claudication, syncope, angina, absent pulses, and unequal blood pressure, often due to stenosis.
- Atypical presentations can delay diagnosis, increasing the risk of morbidity and mortality from irreversible vascular damage.
Purpose of the Study:
- To highlight the importance of early diagnosis of LVV, particularly TAK.
- To emphasize the need for a high index of suspicion for LVV, even with atypical presentations.
- To underscore the crucial role of primary care providers in identifying these conditions early.
Main Methods:
- Case series presentation of three patients diagnosed with LVV.
- Review of clinical presentations, diagnostic processes, and management strategies.
Main Results:
- LVV was identified in three patients presenting with unusual symptoms not typically associated with the condition.
- The cases illustrate the diagnostic challenges posed by atypical LVV presentations.
Conclusions:
- A high index of suspicion is necessary for early LVV diagnosis, especially in primary care.
- Prompt diagnosis and intervention can help arrest inflammation and prevent permanent vascular damage.
- Recognizing atypical presentations is key to improving outcomes for patients with large vessel vasculitis.
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