Zhang Ting, Peng Bo, Tu Xiang, Zhang Shan, Zhong Sen, Cao Wenzhai
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu.
Department of Nursing, Sichuan Vocational College of Health and Rehabilitation, Zigong.
Medicine (Baltimore). 2019 Apr;98(15):e15143. doi: 10.1097/MD.0000000000015143.
Takayasu arteritis (TA) is a chronic inflammatory disease involving the aorta and its major branches. Initial diagnosis is usually difficult due to the highly variable symptoms. Acute myocardial infarction (AMI) is a very rare presentation in patients with TA. Moreover, the choice of early management for these patients is not well established.
A 34-year-old woman was taken to the Emergency Department of our hospital, presenting with a sudden onset and persistent retrosternal chest pain radiating to both upper extremities for 2 hours. Blood pressures were different between 2 arms with 151/115 mm Hg on the right arm and 140/100 mm Hg on the left arm.
The patient was diagnosed with TA according to the medical history, physical examination, and vascular imaging.
Primary percutaneous coronary intervention (PPCI) was performed to restore the coronary flow of left anterior descending. Meanwhile, combination of oral glucocorticoids and immunosuppressive agents was administered to halt disease progression of TA.
Chest pain was relieved without rest and exertional angina. The patient achieved long-term remission without symptom relapse during our follow-up.
Percutaneous coronary intervention was essential and effective in AMI of TA. Timely immunosuppressive therapy could improve the long-term outcome.
大动脉炎（TA）是一种累及主动脉及其主要分支的慢性炎症性疾病。由于症状高度多变，初始诊断通常较为困难。急性心肌梗死（AMI）在TA患者中是一种非常罕见的表现。此外，这些患者的早期治疗选择尚未明确。
一名34岁女性被送往我院急诊科，突发持续性胸骨后胸痛并放射至双上肢2小时。双臂血压不同，右臂为151/115 mmHg，左臂为140/100 mmHg。
根据病史、体格检查和血管成像，该患者被诊断为TA。
进行了急诊经皮冠状动脉介入治疗（PPCI）以恢复左前降支的冠状动脉血流。同时，给予口服糖皮质激素和免疫抑制剂联合治疗以阻止TA疾病进展。
胸痛缓解，无静息性心绞痛和劳力性心绞痛。在我们的随访期间，患者实现了长期缓解，无症状复发。
经皮冠状动脉介入治疗对TA合并AMI至关重要且有效。及时的免疫抑制治疗可改善长期预后。
