Nair Jagdish Ramachandran, Somauroo John D, Over Kathryn E
Department of Rheumatology, Countess of Chester hospital, Chester, UK.
BMJ Case Rep. 2012 Jun 28;2012:bcr1220115469. doi: 10.1136/bcr.12.2011.5469.
Giant cell arteritis (GCA), also known as granulomatous arteritis is a systemic vasculitis mainly affecting extra cranial branches of carotid arteries. It can rarely affect other vascular beds causing thoracic aorta aneurysm, dissection and rarely cause myocardial infarction through coronary arteritis. It can cause considerable diagnostic dilemma due to varied clinical presentations. The authors report an illustrative case of a 70-year-old woman with GCA who developed symptoms suggestive of acute myocardial infarction with chest pain, localised ST-T changes and echocardiographic left ventricular dysfunction. However, cardiac troponin T biomarkers and coronary angiography were normal. Her symptoms subsided with steroid treatment. Cardiac symptoms at first presentation of GCA are unusual.
巨细胞动脉炎(GCA),也称为肉芽肿性动脉炎,是一种主要影响颈动脉颅外分支的系统性血管炎。它很少影响其他血管床,导致胸主动脉瘤、夹层形成,并且极少通过冠状动脉炎引起心肌梗死。由于临床表现多样,它可能会导致相当大的诊断困境。作者报告了一例具有说明性的病例,一名70岁患有GCA的女性出现了提示急性心肌梗死的症状,包括胸痛、局部ST-T改变和超声心动图显示的左心室功能障碍。然而,心肌肌钙蛋白T生物标志物和冠状动脉造影均正常。她的症状通过类固醇治疗得到缓解。GCA初次表现时出现心脏症状并不常见。