Raghuram Karthik, Gopalakrishnan Arun, Nair Krishna Kumar Mohanan, Namboodiri Narayanan, Valaparambil Ajitkumar
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India.
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, India.
Egypt Heart J. 2024 Aug 9;76(1):100. doi: 10.1186/s43044-024-00540-z.
Takayasu arteritis (TA) is a chronic inflammatory disease of unknown etiology characterized by a large vessel vasculitis involving the aorta and its branches. Myocardial involvement is extremely unusual in TA and is mostly in the form of myocarditis, ventricular hypertrophy, and ventricular dysfunction secondary to coronary ischemia. Submitral aneurysms have been reported in TA and has been attributed to the chronic inflammatory process in TA.
We report a novel instance of left ventricular apical aneurysm in a 37-year-old lady with TA and normal epicardial coronaries. She was diagnosed with a left ventricular apical aneurysm, moderate aortic regurgitation, and moderate pericardial effusion. The coronary arteries were normal. The patient had concomitant chronic active Epstein-Barr virus infection complicating patient outcome.
Left ventricular apical aneurysm with normal epicardial coronaries is a rare cause of heart failure in Takayasu arteritis. Concomitant chronic active Epstein-Barr virus infection can potentially accentuate the inflammatory process in Takayasu arteritis and complicate management and patient outcomes.
大动脉炎（TA）是一种病因不明的慢性炎症性疾病，其特征为累及主动脉及其分支的大血管血管炎。TA中心肌受累极为罕见，主要表现为心肌炎、心室肥厚以及继发于冠状动脉缺血的心室功能障碍。TA中已报道有二尖瓣下动脉瘤，这归因于TA中的慢性炎症过程。
我们报告了一例37岁患有TA且心外膜冠状动脉正常的女性发生左心室心尖部动脉瘤的新病例。她被诊断为左心室心尖部动脉瘤、中度主动脉瓣反流和中度心包积液。冠状动脉正常。该患者同时患有慢性活动性EB病毒感染，使患者的病情复杂化。
心外膜冠状动脉正常的左心室心尖部动脉瘤是大动脉炎导致心力衰竭的罕见原因。同时存在的慢性活动性EB病毒感染可能会加重大动脉炎的炎症过程，并使治疗和患者预后复杂化。
