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Valvular disease and myocardial infarctions in a patient with Behçet disease

Michael Schirmer1, Franz Weidinger, Anton Sandhofer

  • 1Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria. michael.schirmer@uibk.ac.at

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|October 17, 2006
PubMed

Insights

Cardiac involvement in Behçet disease (BD) is rare, but this case highlights the risk of severe heart issues like valve regurgitation and myocardial infarction. Early immunosuppression may be key to preventing cardiac complications in BD patients.

Area of Science:

  • Cardiology
  • Rheumatology
  • Immunology

Background:

  • Behçet disease (BD) is a rare multisystem inflammatory disorder.
  • Cardiac involvement in BD is uncommon, affecting less than 5% of patients.
  • Co-occurrence of valvular regurgitation and myocardial infarction in BD is exceptionally rare.

Purpose of the Study:

  • To report a rare case of severe cardiac complications in a patient with Behçet disease.
  • To emphasize the potential for myocardial infarction in BD patients even without atherosclerosis.
  • To highlight the importance of early and adequate immunosuppressive therapy in managing cardiac morbidity in BD.

Main Methods:

  • Case report of a 49-year-old Turkish man with a 6-year history of Behçet disease.
  • Detailed clinical presentation including reduced left ventricular function, aortic and mitral valve replacement.
  • Follow-up included non-ST segment elevation myocardial infarction and ST segment elevation myocardial infarction, with normal coronary angiography and autopsy findings.

Main Results:

  • The patient experienced severe cardiac manifestations, including aortic and mitral valve regurgitation requiring replacement.
  • The patient suffered two distinct myocardial infarction events (NSTEMI and STEMI) within months of valve surgery.
  • Autopsy revealed no atherothrombotic plaques in the coronary arteries, suggesting non-atherosclerotic causes for myocardial infarction.

Conclusions:

  • This case underscores the significant and potentially life-threatening cardiac involvement in Behçet disease.
  • Myocardial infarction can occur in BD patients due to mechanisms other than traditional atherothrombosis.
  • Prompt and effective immunosuppressive treatment is crucial for mitigating cardiac morbidity in Behçet disease.

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