Coronary artery lesions in Takayasu arteritis: Pathological considerations

Abstract

This communication reviews the clinical and pathological features of coronary artery lesions in Takayasu arteritis. The incidence of coronary artery involvement has been reported to be 9% to 10%, and is observed mainly in autopsy cases because coronary artery disease is usually not evident until the occurrence of angina pectoris or myocardial infarction, or after the onset of congestive heart failure. On the basis of pathological features, the following three types of coronary artery lesions can be distinguished: type 1, stenosis or occlusion of the coronary ostia and the proximal segments of the coronary arteries; type 2, diffuse or focal coronary arteritis, which may extend diffusely to all epicardial branches or may involve focal segments, so-called skip lesions; and type 3, coronary aneurysm. Most of the coronary artery lesions in Takayasu arteritis are of type 1. Narrowing of the coronary arteries is mainly due to the extension of the inflammatory processes of proliferation of the intima and contraction of the fibrotic media and adventitia from the ascending aorta. In some cases, coronary stenosis may be caused by coronary arteritis as skip lesions in Takayasu arteritis, but even in these cases the lesions have been reported to affect mainly the proximal segments of the coronary arteries. Diffuse lesions of the coronary artery and coronary artery aneurysm seem to be very rare in Takayasu arteritis. Other causes of coronary ostial stenosis, coronary arteritis and coronary artery aneurysm are also discussed.

A Swelling of the Right Neck and Sudden Death

“…Inflammation and subsequent neointimal proliferation result in stenotic or occlusive lesions, whereas destruction of the elastica and muscularis may cause dilation or aneurysms. 1 Involvement of the coronary arteries is uncommon, [2][3][4] and coronary aneurysms are extremely rare. 5 Either coronary ischemia or aneurysm rupture may be fatal.…”

Untitled

“…Accelerated atherosclerosis caused by vascular inflammation may be another explanation of coronary lesions [5,6]. Doppler ultrasonography, CT and MRI are important tools in diagnosis, but there is no specific imaging technique or serum biomarker.…”

Acute Coronary Syndrome in a Young Lady: A Rare Presentation of Takayasu Disease

“…Accelerated atherosclerosis caused by vascular inflammation may be another explanation of coronary lesions. 5,6 Doppler ultrasonography, CT and MRI are important tools in diagnosis, but there is no specific imaging technique or serum biomarker. Although conventional angiography is the standard imaging technique in TA.…”