Preoperative abnormalities

1. There may be pulse deficits, depending upon the stage of the disease and the arteries involved in the condition. Bruits may be heard over stenosed arteries.There are also ectatic lesions of the aorta with aneurysm formation, but these are much less common than stenoses.

2. Possible cerebrovascular or retinal insufficiency.

3. Renal involvement occurs in 63% of patients.

4. Hypertension, which is most often associated with renal artery stenosis.

5. In type 4 (45%) there may be moderate pulmonary hypertension.

6. Cardiac manifestations have been reported.Whilst cardiac failure can occur as a consequence of either systemic or pulmonary hypertension, valvular disease, most frequently aortic insufficiency, may also occur.

7. The ESR is related to the stage of the disease and is high in 78% of cases, notably in early inflammatory disease.There are ECG abnormalities in 40% and hypergamma-globulinaemia in 37%.

8. The patient may be taking corticosteroids, alone or with immunosuppressive agents.

9. Pregnancy can occur, but tends to be in those with the least severe disease.

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