title: Takayasu arteritis with coronary aneurysms causing acute myocardial infarction in a young man.
abstract: 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.
authors.affiliation: Department of Cardiology, Sahloul Hospital, Sousse 5054, Tunisia. sanaouali@hotmail.fr
authors.forename: Sana
authors.initials: S
authors.lastname: Ouali
authors.forename: Slim
authors.initials: S
authors.lastname: Kacem
authors.forename: Fatma
authors.initials: F
authors.lastname: Ben Fradj
authors.forename: Rim
authors.initials: R
authors.lastname: Gribaa
authors.forename: Elyes
authors.initials: E
authors.lastname: Naffeti
authors.forename: Fahmi
authors.initials: F
authors.lastname: Remedi
authors.forename: Chedia
authors.initials: C
authors.lastname: Laaoueni
authors.forename: Essia
authors.initials: E
authors.lastname: Boughzela
mesh_terms: D000800:Angioplasty, Balloon / Q000295:instrumentation; D054537:Atrioventricular Block / Q000209:etiology; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011237:Predictive Value of Tests; D012078:Renal Artery Obstruction / Q000209:etiology / Q000628:therapy; D015607:Stents; D013625:Takayasu Arteritis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002317:Cardiovascular Agents; D005938:Glucocorticoids