Rapidly Progressive Coronary Aneurysm: A Rare Case of Isolated Coronary Vasculitis With Recurrent Myocardial Infarction

Tiago Rodrigues; Inês Aguiar-Ricardo; Miguel Nobre Menezes; Joana Rigueira; Rafael Santos; Valter Fonseca; Fausto J Pinto; Ana G Almeida

doi:10.1016/j.jaccas.2022.02.022

Rapidly Progressive Coronary Aneurysm: A Rare Case of Isolated Coronary Vasculitis With Recurrent Myocardial Infarction

JACC Case Rep. 2022 May 4;4(9):538-542. doi: 10.1016/j.jaccas.2022.02.022.

Authors

Tiago Rodrigues¹, Inês Aguiar-Ricardo¹, Miguel Nobre Menezes¹, Joana Rigueira¹, Rafael Santos¹, Valter Fonseca², Fausto J Pinto¹, Ana G Almeida¹

Affiliations

¹ Cardiology Department, Santa Maria University Hospital, CHULN, CAML, CCUL, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
² Lisbon School of Medicine, Universidade de Lisboa, Lisbon, Portugal.

Abstract

Isolated coronary arteritis without systemic involvement in adults is exceedingly rare. A 60-year-old patient developed recurrent non-ST-segment elevation myocardial infarctions for 1 year. After an initial coronary angiogram that was normal, serial angiograms showed de novo aneurysm formation. The patient responded favorably to corticosteroids, supporting the diagnosis of isolated coronary arteritis. (Level of Difficulty: Intermediate.).

Keywords: CTA, computed tomographic angiography; DES, drug-eluting stent; LAD, left anterior descending artery; LM, left main; MINOCA, myocardial infarction without obstructive coronary artery disease; NSTEMI, non-ST-segment elevation myocardial infarction; PCI, percutaneous coronary intervention; coronary aneurysms; coronary vasculitis; myocardial infarction without obstructive coronary artery disease (MINOCA); recurrent myocardial infarction.

Publication types

Case Reports