Diagnostic delay and cardiovascular complications in Takayasu arteritis: a case-based review

Takayasu arteritis (TA) is a rare systemic inflammatory disease affecting medium and large arteries, mainly in young Asian women, with a frequency of 1-3 cases per million inhabitants. Diagnosing this disease is challenging due to nonspecific early symptoms, leading to gradual clinical progression until vascular complications appear. A 21-year-old pregnant woman, experiencing progressive mild fatigue, referred for clinical examination. Over the past 3-4 years, she had reported weakness, headache, sweating, and dizziness. Imaging revealed significant vascular damage, including an ascending aortic aneurysm, aortic valve annuloaortic ectasia, aortic, mitral, tricuspid, and pulmonary regurgitation, as well as dilation of the left atrium and left ventricle. While available treatments alleviated symptoms and slowed the progression, late diagnosis resulted in lifelong illness. The diagnostic challenges associated with nonspecific early symptoms and the risk of serious vascular complications underscore the importance of early detection of TA in young women with symptoms of systemic inflammation. Women with TA are more likely to have an unfavourable pregnancy outcomes than the general population. Therefore, such patients need careful monitoring and a collaborative approach to achieve the best possible delivery results. This report aims to compile information on pregnancy in women with TA and how the disease impacts pregnancy progression.