Recurrent myocardial infarction due to coronary artery aneurysm in Behçet's syndrome: a case report

Eur Heart J Case Rep. 2019 Dec;3(4):1-4. doi: 10.1093/ehjcr/ytz204. Epub 2019 Dec 19.

Abstract

Background: Behçet's syndrome (BS) is a multisystemic vasculitis of unknown aetiology. Coronary involvement is extremely uncommon in BS, with a reported prevalence of 0.5%. The mortality of cardiovascular manifestation in BS is 20%, while there are still considerable challenges in the management of these patients.

Case summary: We report the case of a 30-year-old young man with a 12-year history of BS complicated by left anterior descending coronary (LAD) aneurysms, stenosis, and recurrent myocardial infarction. Percutaneous coronary intervention treated the stenosis and aneurysms of the LAD, but the coronary angiography clearly revealed an acute stent thrombosis after 7 months. This unusual coronary complication of BS treated successfully is presented.

Discussion: Our case demonstrated the feasibility of covered stent, immunosuppressive therapy, and escalated antithrombotic regimen in the treatment of BS patients with coronary artery aneurysm (CAA). We also demonstrated that drug-eluting stents may aggravate aneurysmal dilatation of the CAA under inefficient immunosuppressive therapy.

Keywords: Behçet’s disease; Case report; Coronary arteritis; Coronary artery aneurysm.

Publication types

  • Case Reports