Q:

A 23-year-old woman with fever, myalgia and anorexia presents with hypertension and a cool, ischemic left arm. Angiography shows multiple stenoses of the subclavian and renal arteries. The following is/are true:

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A 23-year-old woman with fever, myalgia and anorexia presents with hypertension and a cool, ischemic left arm. Angiography shows multiple stenoses of the subclavian and renal arteries. The following is/are true:


  1. Coronary angiography is indicated with high likelihood of finding coronary disease
  2. Endarterectomy of the lesions would be preferred to transluminal angioplasty
  3. The presentation is more suggestive of Behcet’s disease than Takayasu arteritis
  4. Preferred management consists of corticosteroids

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d. Preferred management consists of corticosteroids

The presentation is most suggestive of Takayasu arteritis which tends not to involve the coronary arteries. A variety of operations have been used in these patients but endarterectomy is not recommended because of a high incidence of early failure. The preferred management is corticosterioids.

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