Wegener's granulomatosis presenting with an acute ST-elevation myocardial infarct (STEMI)

Increased morbidity from ischemic heart disease in patients with Wegener's granulomatosis

“…Although the mechanisms responsible for the enhanced risk of early IHD observed in the present WG cohort cannot be determined from our data set, both disease-specific and therapeutic factors are likely to be of pathogenic importance. Thus, necrotizing vasculitis in cardiac vessels can provoke a clinical picture of MI in WG (30)(31)(32), and some of the early cases of acute MI in our cohort might have been triggered by coronary or myocardial involvement by WG. Furthermore, all patients in our WG cohort received high-dose corticosteroid therapy as part of the first-line immunosuppressive regimen for induction of remission.…”

Acute ST elevation myocardial infarction in fulminant systemic p-ANCA vasculitis: a rare catastrophic complication

“…To the best of our knowledge, this is the first reported case of STEMI in a patient with fulminant anti-MPO+ANCA vasculitis. One case of STEMI was reported by Lazarus et al 5 in a patient with Wegener's (cytoplasmic-ANCA (c-ANCA) positive vasculitis) where coronary involvement was the initial presentation of the disease. Another case was reported in the literature in a woman who had recurrent STEMI, again, in the setting of Wegener's disease 6.…”

Pulmonary Vasculitis

“…Cases of coronary involvement have also been described, but it is unclear if these coronary lesions represent atherosclerosis or true vasculitis (Kozak et al 1995). Patients with GPA (Lazarus et al 2006) and EGPA (Kozak et al 1995) may present with myocardial infarction and abnormal coronary angiography, implying that coronary vasculitis and thrombosis is a direct result of the underlying disease (Kozak et al 1995;Lazarus et al 2006). In some cases, GPA may present with periaortitis (de Roux-Serratrice et al 2002).…”