Takayasu arteritis presenting with total occlusion of the left main coronary artery ostium: an extremely rare occurrence

Abstract

SUMMARYA young 18-year-old female patient with exertional angina and claudication of the upper limbs was subjected to angiography. Bruits were auscultated over the bilateral renal arteries, right subclavian and right common carotid arteries. There was asymmetry of peripheral pulses. Laboratory parameters demonstrated a high erythrocyte sedimentation rate and C reactive protein. An aortic angiogram revealed a typical picture of Takayasu arteritis with bilateral subclavian, common carotid and renal involvement. A coronary angiogram was performed which showed total occlusion of the left main coronary artery. There was retrograde filling of the left coronary artery on right coronary artery injection up to the ostium of the left main coronary artery. Since the markers for disease activity were high, the patient was started on steroids and urgent coronary artery bypass grafting was planned. Unfortunately, the patient refused urgent intervention and was later lost to follow-up. This case describes an extremely rare occurrence of total occlusion of the left main coronary artery ostium in a patient with Takayasu arteritis. BACKGROUND

A Case Report: An Elderly Male Patient With Takayasu Arteritis After Coronary Artery Bypass Grafting

“…Most adult cases are female, with an incidence rate of 90%, and the age of the onset is relatively small, usually between 20 and 40 years (6). Another study found that the incidence rate of TA in children showed different male-to-female ratios (7,8). A Japanese study showed that among newly diagnosed patients with TA, although male patients were significantly less than female patients, the median age of the onset of male patients was significantly higher than that of female patients, and male patients usually had extensive aortic lesions or aneurysms and more complications (9).…”