Cui Xiaoxian, Peng Yang, Liu Jun, Dong Yugang, Wu Zexuan, Chen Yili
Respiratory Department, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Front Cardiovasc Med. 2021 Nov 12;8:731897. doi: 10.3389/fcvm.2021.731897. eCollection 2021.
Eosinophilic granulomatosis with polyangitis manifested as myocardial infarction with non-obstructed coronary arteries (MINOCA) is rarely reported. We report a 43-year-old male patient without any cardiovascular risk factors presenting with acute chest pain. Electrocardiogram was suggestive of acute anterior and inferior myocardial infarction. MINOCA was confirmed based on significant elevated cardiac troponin and normal coronary arteries. Cardiac magnetic resonance (CMR) imaging revealed extended late gadolinium enhancement (LGE). Further diagnosis of eosinophilic granulomatosis with polyangitis (EGPA) was based on clinical manifestations and auxiliary examination. Subsequent immunosuppressive therapy led to regression of symptoms and significant resolution of LGE on CMR. Our case highlights that EGPA can be a rare cause of MINOCA. CMR is useful for differentiation diagnosis and evaluation of cardiac involvement.
表现为非阻塞性冠状动脉心肌梗死（MINOCA）的嗜酸性肉芽肿性多血管炎鲜有报道。我们报告一名43岁无任何心血管危险因素的男性患者，其出现急性胸痛。心电图提示急性前壁和下壁心肌梗死。基于心肌肌钙蛋白显著升高和冠状动脉正常确诊为MINOCA。心脏磁共振（CMR）成像显示延迟钆增强（LGE）范围扩大。根据临床表现和辅助检查进一步诊断为嗜酸性肉芽肿性多血管炎（EGPA）。随后的免疫抑制治疗使症状消退，CMR上LGE明显消退。我们的病例强调EGPA可能是MINOCA的罕见病因。CMR有助于鉴别诊断和评估心脏受累情况。
