Improving pulmonary perfusion in a child with Takayasu's art
Takayasu's arteritis (TA) is a form of granulomatous arteritis of unknown etiology. Published in the Indian Journal of Vascular and Endovascular Surgery, the authors describe a report of a 14-year-old boy with TA and disabling pulmonary compromise, who was treated by PA angioplasty and stenting.

A 14-year-old boy was referred for the evaluation and management of TA. He was a known case of TA involving aortic arch and its branches and was on medical management (corticosteroids and other immunosuppressive drugs) for the last 8 months. On admission, he presented with difficulty in breathing on walking a few steps and sometimes at rest, generalized weakness, and occasional fever for the last 1 month.

His hemodynamic parameters were normal (blood pressure 130/80 bilaterally, heart rate 98 beats/min), except tachypnea (respiratory rate 34/min). Oxygen saturation was 76% on room air and 100% with 5 l of oxygen. Auscultation and percussion were unremarkable, except for the absence of breath sounds in the right lower zone. Left carotid and left brachial pulse were weak compared to the opposite side. His hemoglobin was 10 g/dl, erythrocyte sedimentation rate 9 mm/h, and C-reactive protein 7.68.

The chest X-ray revealed mild cardiomegaly with prominent main PA contours and haziness in the right middle and lower lobe. ECHO was suggestive of severe pulmonary arterial hypertension (PAH).

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