Takayasu arteritis masquerading as stable angina in a 29-year-old man

• Published in: The American journal of emergency medicine 2017-04, Vol.35 (4), p.663.e3-663.e4
• Main Authors: Wang, Lei, MD, Ma, Teng, MD, Zhao, Yun-Tao, MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Angina; Angina pectoris; Angina, Stable - diagnosis; Angiography; Aorta; Arteritis; Atherosclerosis; Cardiovascular disease; Case reports; Celiac Artery - diagnostic imaging; Computed tomography; Computed Tomography Angiography; Coronary Angiography; Coronary artery; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - drug therapy; Coronary Stenosis - etiology; Coronary vessels; Cyclophosphamide - therapeutic use; Deoxyglucose; Diagnosis, Differential; Emergency; Emergency medical care; Family medical history; Glucocorticoids - therapeutic use; Heart surgery; Humans; Immunoglobulins; Immunosuppressive Agents - therapeutic use; Laboratories; Magnetic resonance imaging; Male; Mens health; Patients; Positron emission tomography; Prednisone - therapeutic use; Pulmonary artery; Rare diseases; Rheumatology; Stenosis; Stents; Subclavian Steal Syndrome - diagnostic imaging; Subclavian Steal Syndrome - drug therapy; Subclavian Steal Syndrome - etiology; Takayasu arteritis; Takayasu Arteritis - complications; Takayasu Arteritis - diagnosis; Takayasu Arteritis - drug therapy; Takayasu's disease; Tomography, X-Ray Computed; Vasculitis; Vein & artery diseases
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2016.10.071

Abstract Takayasu arteritis is a form of vasculitis that involves the aorta, its major branches, and the pulmonary arteries. Coronary artery involvement is not uncommon, and most frequently includes the ostia and proximal segments. Early diagnosis of Takayasu arteritis is difficult since it is a rare disease and is accompanied by various nonspecific clinical symptoms. However, recent advances in imaging modalities—including magnetic resonance angiography, computed tomography (CT), sonography, and fluoro-deoxyglucose positron emission tomography (FDG-PET)/CT Isobe (2013) [2] —have facilitated earlier and more accurate diagnoses of this condition. Here we report a case in which imaging revealed stenosis in the ostia of the coronary artery.