Acute myocardial infarction and left subclavian artery occlusion in Behçet's disease: a case report

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Vascular Surgery

Background:

• Behcet's disease is a rare multisystem inflammatory disorder.
• Vascular involvement is a serious complication of Behcet's disease, affecting both arteries and veins.
• This case highlights the potential for extensive arterial disease in patients with Behcet's disease.

Observation:

• A 42-year-old woman with a 14-year history of Behcet's disease and pericardial effusion presented with acute myocardial infarction.
• Coronary angiography revealed total occlusion of the left anterior descending artery, treated with coronary artery bypass grafting using the left internal mammary artery.
• A year later, she developed chest and left arm pain, leading to angiography showing total occlusion of the left subclavian artery with retrograde filling from the left vertebral artery.

Findings:

• Behcet's disease can lead to progressive occlusion in multiple major arteries, including coronary and subclavian arteries.
• The vasculitis associated with Behcet's disease poses a risk of graft occlusion.
• This case demonstrates a pattern of severe, multi-site arterial involvement in a patient with Behcet's disease.

Implications:

• Patients diagnosed with arterial involvement in Behcet's disease necessitate comprehensive vascular screening to detect additional affected vessels.
• The use of free arterial grafts in coronary artery bypass surgery for patients with Behcet's disease should be carefully considered due to potential occlusion risks.
• Further research into optimal surgical strategies and long-term outcomes for arterial reconstruction in Behcet's disease is warranted.