Department of Cardiology, The First People's Hospital of Tianmen, Tianmen, 431700, China.
Department of Cardiology, The First People's Hospital of Jining, Jining, 272000, China.
J Cardiothorac Surg. 2021 Nov 21;16(1):339. doi: 10.1186/s13019-021-01725-2.
Although not common, coronary artery aneurysms (CAAs) can develop to over 8 mm in diameter to become giant CAAs. In the context of systemic lupus erythematosus (SLE), autoantibody- and immune complex-mediated atherosclerosis is believed to be the most prevalent cause of aneurysm.
We report the case of a 53-year-old female SLE patient who presented to our hospital with radiating chest pain. Coronary angiography revealed a giant aneurysm in the middle segment of the left anterior descending artery (LAD) and distal subtotal occlusion in the left circumflex artery (LCX). Laboratory testing also identified risk factors such as an abnormal pulmonary enzyme profile, dyslipidemia, and nephritis parameters.To prevent thromboembolism, anticoagulation and antiplatelet therapy were administered. In addition, one stent was implanted at the distal end of the LCX and repeated coronary angiography verified restoration of TIMI grade III flow.The patient was discharged with resolved chest pain. During 6 months of follow-up, the patient is in good health.
Our case study, together with 16 recent comparable reports, emphasizes the need for coronary aneurysm screening in SLE patients. It is necessary that thromboembolism, anticoagulation and antiplatelet therapy were administered for CAA.
虽然并不常见，但冠状动脉瘤（CAA）可发展至超过 8mm 直径而成为巨大冠状动脉瘤。在系统性红斑狼疮（SLE）的背景下，自身抗体和免疫复合物介导的动脉粥样硬化被认为是动脉瘤最常见的原因。
我们报告了一例 53 岁的女性 SLE 患者，因放射状胸痛就诊于我院。冠状动脉造影显示左前降支中段有巨大动脉瘤，左回旋支远段次全闭塞。实验室检查还发现了一些风险因素，如肺酶谱异常、血脂异常和肾炎参数。为了预防血栓栓塞，给予抗凝和抗血小板治疗。此外，在 LCX 的远端植入了一个支架，并进行重复冠状动脉造影以验证 TIMI 血流恢复到 III 级。患者胸痛缓解后出院。在 6 个月的随访期间，患者身体状况良好。
我们的病例研究以及最近的 16 例类似病例报告强调了 SLE 患者进行冠状动脉瘤筛查的必要性。对于 CAA，需要进行血栓栓塞、抗凝和抗血小板治疗。
