Takayasu Arteritis treated at SKY Hospital

11th May, 2019

Digital Subtraction Angiogram (DSA) for diagnosis of Takayasu Arteritis (Fig.1)

Miss Jessica (name changed), 20 years, daughter of K. Ngaoshoni of Senapati District was successfully treated at SKY Hospital. Imphal West. She was admitted as an emergency on 23rd April, 2019 with severe heart failure, severe tachycardia (high pulse rate), hypoxia (low body oxygen) and breathlessness. Within minutes she was provided with an Echocardiogram (heart scan) confirming the diagnosis of severe heart failure with Left Ventricular Ejection Fraction (LVEF) at only 29.3% (normal >= 55%).

She was also found to have leaking of main heart valves Aortic valve and Mitral valve with moderate severity. Within 24 hours, a clinical diagnosis of Takayasu Arteritis was made and appropriate treatment was initiated.

Subsequently, a specialised test called Digital Subtraction Angiogram (DSA) using Philip’s Cath Lab camera confirmed the diagnosis of Takayasu Arteritis causing moderate aortic regurgitation, dilated aortic root, ascending aorta, aortic arch and severe narrowing of left subclavian artery (Fig.1).

The final confirmed was therefore Takayasu Arteritis involving heart with myocarditis and heart failure, moderate aortic regurgitation, moderate mitral regurgitation, moderately dilated ascending aorta with involvement of its main branches and severe narrowing of left subclavian artery.

Patient’s condition started improving very promptly and was able to eat and drink at Day 3 of starting treatment. A repeat Echo done on Day 7 of treatment showed that the heart function improved significantly from LVEF 29.3% to 50% in just 7 days. Miss Jessica started to mobilise and was discharged home on 3rd May, 2019 (Fig.2).

Happy patient, family with Dr. L. Shyamkishore, Chief Cardiologist of SKY Hospital

Notably, Dr. L. Shyamkishore is among the team of cardiologists of AIIMS who advocated the effective drug treatment of the condition for the first time in the world in 1988. This was his thesis for the post-doctorate degree (DM) in Cardiology at AIIMS, 1986-88.

The original thesis is available at AIIMS Library and SKY Hospital’s library (author’s copy) and the article on this subject published in International Journal of Cardiology, 23 (1988) 323 – 334 is also available on the internet.

Dr. L. Shyamkishore, Chief Cardiologist of SKY Hospital asserted that the life of a young girl whose heart problem remained undiagnosed for 12 months despite seeing many doctors during that period, accurately diagnosed at her first visit to SKY was saved with appropriate treatment.

He further appealed to the people of Manipur to be aware of this rare and deadly disease among young women which can be 100% diagnosed with sophisticated diagnostic tests with DSA and Endo-myocardial biopsy both of which are readily available at SKY Hospital.

He also stated that although Takayasu Arteritis, a rare disease in Europe and North America (1 – 2/millions hospital admitted patients) is not uncommon among the people of North Eastern India and Eastern Asia.

Diagnosis of this disease may be challenging as in the patient but can be made with accuracy at SKY Hospital. Dr. L. Shyamkishore is developing SKY Hospital as a Centre of Clinical Excellence for Takayasu Arteritis’s diagnosis and treatment.

Roni
SKY Hospital & Research Centre Pvt. Ltd.
RIMS Road, Imphal (West) -795004, Manipur