Cardiac denervation procedure to treat refractory angina in a patient with Churg-Strauss syndrome and non-obstructive coronary lesions

Abstract

Cardiac involvement in Churg-Strauss syndrome is common and represents the main cause of mortality. We report the case of a patient with Churg-Strauss vasculitis, mitral regurgitation with left ventricular dysfunction, paroxysmal atrial fibrillation and refractory angina with non-significant coronary lesions. Cardiac denervation was proposed as an associated procedure to treat angina. The total removal of peri-adventitial and adventitial tissue around the superior vena cava, ascending aorta and main pulmonary trunk was performed. After 3 months of follow-up, the patient was angina-free and could resume his normal lifestyle.

Cardiac Involvement in Eosinophilic Granulomatosis with Polyangiitis: A Meta-analysis of 62 Case Reports

“…Two of the patients with significant atherosclerotic coronary lesions were accordingly treated with revascularization (percutaneous coronary intervention in 1 and coronary bypass in the other) or medical therapy based on the suspected etiology. In a unique case reported by Cura et al, 17 refractory chest pain was successfully controlled with cardiac denervation in the patient with nonsignificant coronary lesions whose chest pain was probably due to coronary spasm.…”

“…Coronary vasospasm has been considered the main cause of chest pain in patients with EGPA without significant coronary disease. 17 Coronary ectasia is previously reported in many systemic inflammatory vasculitis, and it is associated with ectasia in other arterial beds such as the kidney and brain vasculature. 41 …”