Death due to severe occlusion of the subclavian artery; a case report

Abstract

Takayasu arteritis is a rare, large vessel disease. It commonly affects aorta and its main branches. The characteristic features are absent or diminished pulse, vascular bruits, hypertension, chest pain, retinopathy, and dyspnoea. Some studies have shown that there is an association between hypothyroidism and Takayasu arteritis. We report a death of a 56-year-old female with suggestive symptoms of Takayasu Arteritis. She was diagnosed to have diabetes mellitus and ischaemic heart disease for 10 years. Lately, she was suffering from upper and lower limb pain. Three days before she died she developed severe limb pain and swelling of the body including upper and lower limbs. She was admitted to the tertiary care hospital and died on the following day. The electrocardiography showed subtle ischemic changes. Laboratory investigations were performed due to body swelling which confirmed hypothyroidism. At autopsy, there were severe occlusions of the left subclavian artery and severe stenosis of all coronary arteries. Histological examinations were performed since these findings are commonly seen in Takayasu arteritis. However, microscopy of Haematoxylin and Eosin stains revealed the occlusions in the left subclavian artery as atherosclerotic. Cause of death was given as atherosclerotic heart disease.