Takayasu arteritis with coronary aneurysms causing acute myocardial infarction in a young man

• Published in: Texas Heart Institute journal 2011, Vol.38 (2), p.183-186
• Main Authors: Ouali, Sana, Kacem, Slim, Ben Fradj, Fatma, Gribaa, Rim, Naffeti, Elyes, Remedi, Fahmi, Laaoueni, Chedia, Boughzela, Essia
• Format: Article
• Language: English
• Subjects: Angioplasty, Balloon - instrumentation; Atrioventricular Block - etiology; Cardiovascular Agents - therapeutic use; Case Reports; Coronary Aneurysm - diagnosis; Coronary Aneurysm - drug therapy; Coronary Aneurysm - etiology; Coronary Angiography; Diagnosis, Differential; Electrocardiography; Glucocorticoids - therapeutic use; Humans; Male; Myocardial Infarction - diagnosis; Myocardial Infarction - drug therapy; Myocardial Infarction - etiology; Predictive Value of Tests; Renal Artery Obstruction - etiology; Renal Artery Obstruction - therapy; Stents; Takayasu Arteritis - complications; Takayasu Arteritis - diagnosis; Takayasu Arteritis - drug therapy; Treatment Outcome; Young Adult
• ISSN: 0730-2347; 1526-6702

Takayasu arteritis is an inflammatory condition that involves the large cardiac vessels, predominantly the aorta and its main branches. It typically affects young women (age, ≤40 yr), most often Asians and Latin Americans. Herein, we describe a rare manifestation of Takayasu arteritis in a 19-year-old black Tunisian man who presented with acute inferior myocardial infarction and complete atrioventricular block after occlusion from a giant aneurysm in the right coronary artery. The coronary artery disease was associated with aneurysmal dilations in the carotid, vertebral, and right renal arteries. Medical therapy improved Thrombolysis in Myocardial Infarction flow in the area of the giant aneurysm from grade 1 to grade 3. Upon the diagnosis of Takayasu arteritis, intravenous methylprednisolone and oral prednisone therapy was started. After 10 days of hospitalization, the patient was discharged on a medical regimen. Renovascular hypertension due to renal artery stenosis was suspected, so he underwent successful percutaneous transluminal angioplasty of the inferior segmental artery of the right renal artery. During 12 months of close postprocedural monitoring, he experienced lower blood pressure, no chest pain, and no cardiovascular complications.This association of conditions has not been previously reported. Besides presenting this very rare combination of findings, we discuss the differential diagnosis of Takayasu arteritis in our patient.