A 13-year-old girl complains of fatigue and chest pain, and has persistent low-grade fever. Initially, these are taken for typical excuses for truancy among school students.
But, going by her good academic record, her mother is convinced that there is something wrong with the girl’s health.
Initial consultations with doctors yield only multi-vitamin supplements and antibiotics. Later, intensive checks at a hospital in Kozhikode reveal an inflammation in the artery in the heart – Takayasu’s Arteritis.
This is not a congenital defect. The inflammation occurs in children and adults and is suspected to be an autoimmune disease (wherein the immune system itself attacks healthy tissues, instead of resisting antigens such as virus and bacteria),” says Paediatric Cardiologist at Aster MIMS, Kozhikode, Renu P. Kurup, who treated the girl.
Takayasu Arteritis is a chronic disease and may need long-term treatment. Even after a treatment regimen, it might recur or worsen silently. Therefore, patients need to have regular check-up and tests.
Since it is very rare in children, the diagnosis is often missed. Such an undiagnosed inflammation of major arteries could lead to heart and kidney failure.
“It is not clear what causes it. We only assume it could be an autoimmune disease. Such cases are put on a judicious mix of immuno-modulator drugs and steroids,” she says.
What the doctor stresses through this case is that when a child or an adult complains of such symptoms, along with chest pain, it is better to look deeper for a possible inflammation of an artery. This could affect any artery, and when it hits one in the heart there is need for swift intervention.
The inflammation could dilate the aorta, which supplies blood from the heart to various parts of the body.
Eventually, this could lead to aneurysm – a bulge in the aorta.
The bulge stretches and thins the wall of the aorta, and a burst could result in death.
In the girl’s case, the inflammation had also narrowed the origin of the left sub-clavian artery that supplied blood to the left hand.
In adults with Takayasu’s Arteritis, a stent could be passed into a narrowed artery to enable normal blood supply. “But this cannot be done in growing children. That is why they have to be put on steroids and immuno-modulator drugs,” Dr. Renu explains.
K.V. Prasad
