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Images in paediatrics
Tricky case of Takayasu arteritis in a young child presenting with heart failure and femoral pulses
  1. Marianna Fabi1,
  2. Maurizio Brighenti1,
  3. Andrea Donti1,
  4. Marcello Lanari2
  1. 1 Pediatric Cardiology and Adult Congenital Unit, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola - Malpighi University Hospital, Bologna, Italy
  2. 2 Pediatric Emergency Unit, Università degli Studi di Bologna Azienda Ospedaliera Sant’Orsola-Malpighi, Bologna, Italy
  1. Correspondence to Dr Marianna Fabi, Pediatric Cardiology and Adult Congenital Unit, Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola - Malpighi University Hospital, Bologna 40138, Italy; marianna.fabi{at}aosp.bo.it

https://doi.org/10.1136/archdischild-2017-314663

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    A 6-year-old African girl was admitted with heart failure, tachycardia with gallop rhythm and hepatomegaly. Peripheral pulse examination showed absence of the right brachial and carotid pulses, but femorals were palpable; and right carotid and paraumbilical systolic murmurs were noted. Four limbs’ blood pressure discrepancy was present (right arm 100/70 mm Hg, left arm 141/87 mm Hg, right leg 123/82 mm Hg, left leg 117/76 mm Hg). Echocardiography showed left atrial and ventricular dilatation and severe dysfunction, with normal aortic arch but abdominal coarctation. CT angiography showed occlusion of the brachiocephalic trunk, and the right subclavian artery, as well as stenosis of the right common carotid artery, and abdominal coarctation at …

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    Footnotes

    • Contributors MF wrote the first draft of the manuscript. MB revised the text and the bibliography. AD and ML performed and chose the imaging tests, and revised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Parental/guardian consent obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data sharing statement Additional data are available regarding clinical condition of the patient and follow-up if requested. Also CT additional images are available if requested.