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Multiple coronary aneurysms in a case of systemic lupus erythematosus

A H Matayoshi1, M R Dhond, L J Laslett

  • 1Department of Medicine, Division of Cardiology, University of California at Davis Medical Center, Sacramento, CA 95817, USA.

Chest
|October 26, 1999
PubMed

Insights

Systemic lupus erythematosus (SLE) can cause rare coronary artery aneurysms. This case presents extensive aneurysmal dilation involving all three major coronary arteries, a finding not previously reported in SLE patients.

Area of Science:

  • Cardiology
  • Rheumatology
  • Immunology

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
  • Cardiac involvement in SLE can range from pericarditis to myocarditis and coronary artery disease.
  • Coronary artery aneurysms are uncommon but recognized complications in patients with SLE.

Observation:

  • A 29-year-old woman with active SLE presented with an anterior myocardial infarction.
  • Coronary angiography revealed multiple, diffuse aneurysms affecting all three major coronary arteries: the left anterior descending, left circumflex, and right coronary arteries.
  • This extensive aneurysmal involvement represents a unique angiographic finding.

Findings:

  • The patient's presentation highlights a rare and severe manifestation of cardiovascular involvement in SLE.
  • The diffuse, multi-vessel coronary artery aneurysms observed are unprecedented in the reported literature for SLE.
  • This case expands the spectrum of known cardiac complications associated with active SLE.

Implications:

  • This case underscores the importance of considering coronary artery aneurysms in SLE patients presenting with myocardial infarction.
  • Further research is warranted to elucidate the pathogenesis of extensive coronary aneurysms in SLE.
  • Early recognition and management strategies for this rare complication may improve patient outcomes.

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