Takayasu’s arteritis presenting as acute myocardial infarction: case series and review of literature

Abstract

This series describes three adolescent females who presented with chest pain and ventricular dysfunction related to acute coronary ischemia secondary to Takayasu’s arteritis with varied courses of disease progression leading to a diverse range of therapies including cardiac transplantation. While Takayasu’s arteritis is rare in childhood, it should be strongly considered in any adolescent female presenting with systemic inflammation and chest pain consistent with myocardial infarction. A high index of suspicion can lead to early detection and aggressive management of the underlying vasculitis reducing associated morbidity and mortality. The purpose of this report is to describe the challenges in the clinical diagnosis and management of Takayasu’s arteritis with myocardial infarction. We also seek to enhance awareness about unique presentations of Takayasu’s arteritis within the paediatric community.

Clinical and vascular lesion characteristics of the patients with takayasu arteritis manifested firstly as acute myocardial infarction at onset

“…The proportion of coronary arteries involvement in patients with TA is about 9–10% [ 1 , 4 , 5 , 14 , 24 ]. TA mainly involves the ostia and proximal segment of coronary artery, showing the lesions of stenosis, occlusion or dilatation, which result in myocardial ischemia, angina pectoris or AMI [ 4 , 25 ]. Six cases described in the study all suffered from the ostia involvement of the LM and/or RCA.…”

Clinical characteristics and risk factors of coronary artery lesions in chinese pediatric Takayasu arteritis patients: a retrospective study

“…8 ] . Wilson et al [ 9 ] presented three adolescent females with TAK and MI who underwent balloon angioplasty, three-vessel coronary artery bypass grafting, and cardiac transplantation. When complicated by coronary abnormalities, the prognosis is generally poor because of the non-specificity of clinical manifestations with delayed diagnosis and difficulty of treatment.…”

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

“…TA, which is also called “pulseless disease”, is a rare systemic granulomatous inflammatory vasculitis with an unknown etiology. 1 TA is rare and occurs at a rate of <3 per million people in Western countries. 2 TA is more prevalent in women of childbearing age and in Asian populations.…”