Isolated Coronary Vasculitis as a Cause of Acute Myocardial Infarction: A Diagnostic Dilemma

Kinno, Menhel; Mathenge, Njambi; Patel, Monali; Niazi, Osama Tariq; Tashman, Ra'Ad; Lichtenstein, Seth J.; Tariq, Umair; Dominguez, Yulanka Castro; Boppana, V. Subbarao; Saeed, Qaisra

doi:10.1016/s0735-1097(16)31157-3

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“…CAV represent an important differential diagnoses to consider, in younger patients with unexplained acute coronary syndromes (ACS) or congestive cardiac failure, especially in the setting of a known primary or secondary vasculitis [ 4 ]. These events may be principal manifestations in the younger population, who do not have traditional Framingham cardiovascular risk factors [ 5 ]. A high index of clinical suspicion is required for appropriate work-up, especially as initial investigative modalities carry variable levels of diagnostic sensitivity or specificity.…”

Section: Introductionmentioning

confidence: 99%

Coronary artery vasculitis: a review of current literature

Khanna

Garikapati

Goh

et al. 2021

BMC Cardiovasc Disord

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Cardiac vasculitis is recognized as a heterogeneous disease process with a wide spectrum of manifestations including pericarditis, myocarditis, valvular heart disease and less frequently, coronary artery vasculitis (CAV). CAV encompasses an emerging field of diseases which differ from conventional atherosclerotic disease and have a proclivity for the younger population groups. CAV portends multiple complications including the development of coronary artery aneurysms, coronary stenotic lesions, and thrombosis, all which may result in acute coronary syndromes. There are several aetiologies for CAV; with Kawasaki’s disease, Takayasu's arteritis, Polyarteritis Nodosa, and Giant-Cell Arteritis more frequently described clinically, and in literature. There is a growing role for multi-modality imaging in assisting the diagnostic process; including transthoracic echocardiography, cardiac magnetic resonance imaging, computed tomography coronary angiography, fluorodeoxyglucose-positron emission tomography and conventional coronary angiogram with intravascular ultrasound. Whilst the treatment paradigms fundamentally vary between different aetiologies, there are overlaps with pharmacological regimes in immunosuppressive agents and anti-platelet therapies. Interventional and surgical management are is a consideration in select populations groups, within a multi-disciplinary context. Further large-scale studies are required to better appropriately outline management protocols in this niche population.

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Section: Introductionmentioning

confidence: 99%