Ouali Sana, Kacem Slim, Ben Fradj Fatma, Gribaa Rim, Naffeti Elyes, Remedi Fahmi, Laaoueni Chedia, Boughzela Essia
Department of Cardiology, Sahloul Hospital, Sousse 5054, Tunisia.
Tex Heart Inst J. 2011;38(2):183-6.
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.
高安动脉炎是一种炎症性疾病，累及大的心脏血管，主要是主动脉及其主要分支。它通常影响年轻女性（年龄≤40岁），最常见于亚洲人和拉丁美洲人。在此，我们描述了一名19岁的突尼斯黑人男性高安动脉炎的罕见表现，他因右冠状动脉巨大动脉瘤闭塞后出现急性下壁心肌梗死和完全性房室传导阻滞。冠状动脉疾病与颈动脉、椎动脉和右肾动脉的动脉瘤样扩张有关。药物治疗使巨大动脉瘤区域的心肌梗死溶栓血流从1级改善到3级。在诊断为高安动脉炎后，开始静脉注射甲泼尼龙和口服泼尼松治疗。住院10天后，患者出院并接受药物治疗。怀疑因肾动脉狭窄导致肾血管性高血压，因此他成功接受了右肾动脉下段经皮腔内血管成形术。在术后12个月的密切监测期间，他血压降低，无胸痛，也无心血管并发症。这种情况的关联此前尚未见报道。除了呈现这种非常罕见的综合表现外，我们还讨论了该患者高安动脉炎的鉴别诊断。
