Porcelain aorta associated with longstanding Takayasu arteritis

A 58-year-old female presented in our hospital with recurrent dizziness, chest tightness, and lower limb oedema for 2 years. She was diagnosed with Takayasu arteritis 39 years ago, which manifested with fever and fatigue, and her symptoms relieved after receiving glucocorticoid therapy for 1 year. On physical examination, her blood pressure was 123/53 mmHg in the left arm and 100/54 mmHg in the right arm. Pulses of limbs were easily palpable, but pulsation of left carotid artery was significantly weaker than right side. Furthermore, a moderate diastolic heart murmur could be heard on auscultation. Blood tests showed normal levels for C-reactive protein, erythrocyte sedimentation rate, and troponin T, but an increased level of NT-proBNP (3270 pg/mL, normal range: 0–125pg/mL). Computed tomography angiography (CTA) revealed extensive calcification of the entire aorta, stenosis of left common carotid artery, and dilatation of ascending aorta (Panels A–D) (Supplementary data online,...