Acute non-ST segment elevation myocardial infarction as the first manifestation of Takayasu arteritis in a 16-year-old female patient: a case report and literature review

Abstract

Takayasu arteritis (TA) is now recognized worldwide and is a disease that mainly affects the aorta and its main branches. TA rarely involves the small or medium-sized vessels. Certain vascular lesions, such as arterial stenosis, occlusion, and aneurysm are common with TA. However, patients with new-onset TA who present with left main trunk acute non-ST segment elevation myocardial infarction are extremely rare. We report a 16-year-old female patient with non-ST segment elevation myocardial infarction due to severe stenosis of the left main coronary artery that was caused by TA. She was eventually diagnosed with TA and underwent successful coronary artery stenting combined with glucocorticoids and folate reductase inhibitor therapy. Over the 1-year follow-up, she experienced two episodes of chest pain and was admitted to the hospital. During the second hospitalization, coronary angiography (CAG) revealed 90% stenosis of the original left main trunk (LM) stent. Following percutaneous coronary angiography (PTCA), drug-coated balloon (DCB) angioplasty was performed. Fortunately, a clear diagnosis of TA was made, and treatment was initiated with an interleukin-6 (IL-6) receptor inhibitor. Early diagnosis and therapy for TA are emphasized.

Research progress of drug eluting balloon in arterial circulatory system

“…The long-term consequences of coronary stent implantation in children remain uncertain, thus opting for a “stent-less intervention” strategy seems more favorable for the long-term prognosis of pediatric patients. Wang et al described a case involving a 16-year-old female patient who experienced a non-ST-segment elevation infarction caused by aortitis, and subsequently underwent drug-coated balloon angioplasty for in-stent restenosis that occurred one year after coronary stent implantation ( 58 ). Xu et al reported the successful treatment of severe stenosis of the proximal left anterior descending coronary artery caused by Kawasaki disease in a 6-year-old boy using drug-coated balloon revascularization, demonstrating the feasibility of this treatment approach in children with Kawasaki disease ( 59 ).…”