Takayasu arteritis--beyond pulselessness.

Takayasu Arteritis is a chronic vasculitis, mainly involving the aorta and its main branches, as well as the coronary and pulmonary Arteritis to cause stenosis, and/or obstruction due to thrombusformation or aneurysmalformation and/or rupture of the involved arteries (1, 2) (Fig. 1). The first description of this morbid condition was reported in 1830 by Yamamoto in Japan (3). However, the first scientific presentation of Takayasu Arteritis was given in 1905 at the 12th annual meeting of the Japan Ophthalmology Society in Fukuoka by Mikito Takayasu describing a case of a 21-yearold girl who showed a peculiar optic fundal appearances characterized by coronary anastomosis (4, 5) (Fig. 2). This disease has cometo be called Takayasu Arteritis in honor of the first reporter. At that meeting Drs. Ohnishi and Kagoshima each presented similar cases and, furthermore, both pointed out that in their patients no radial pulse could be palpated. In 1940 Ohta confirmed that this characteristic optic fundal feature resulted in ischemia due to the obstruction of cervical vessels shown in Fig. 1 (6). Shimizu and Sano in 1951, summarized the clinical features of the first 25 reported cases and their ownsix cases in an English language paper under the name of "pulseless disease" (7). Hence, in Western countries this morbid condition became well knownas "Pulseless Disease" which later led to some confusion and misunderstanding of this disease.