Acute Inferior Myocardial Infarction as the First Manifestation of Takayasu Arteritis in a Young Boy
نویسندگان
چکیده
The patient, a male student, 17‐year‐old, was admitted to our emergency room with persistent retrosternal pain accompanied by sweat 2 h. The patient had no history of hypertension or diabetes, and he neither drank alcohol nor smoked. There was no family history of coronary heart disease. On his physical examination, blood pressure of left arm was 140/70 mmHg and 100/70 mmHg for the right. Vascular murmur can be heard in the neck , supraclavicular and groin area. His initial electrocardiogram revealed II, III, avF ST‐segment elevation 0.6–0.7 mV, laboratory test revealed a markedly elevated troponin I (>100 ng/ml), so we considered Takayasu’s arteritis could not be excluded. We performed emergency percutaneous coronary interventional therapy. Coronary angiography revealed that the middle of the right coronary artery was totally occlusive [Figure 1a]. The proximal stenosis of left anterior descending branch was 50% and formed collateral circulation to the distal right coronary artery [Figure 1b]. Therefore, drug‐eluting stent was implanted in the occlusion of right coronary artery [Figure 1c]. On the 2nd day of admission, his C‐reactive protein level (20 mg/dl) and erythrocyte sedimentation rate (48.7 mm/h) were high. After 4th day of stenting, large vessel computed tomography (CT) was performed. CT angiography of the aorta showed that bilateral proximal subclavian arteries, internal carotid artery and renal artery had severe stenosis, celiac trunk had moderate stenosis. The superior mesenteric artery had severe stenosis.
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عنوان ژورنال:
دوره 128 شماره
صفحات -
تاریخ انتشار 2015