Emergency percutaneous coronary dilatation for acute myocardial infarction in Behçet's disease

Area of Science:

• Cardiology
• Rheumatology
• Vascular Medicine

Background:

• Behçet's disease is a rare multisystem inflammatory disorder.
• Coronary artery involvement in Behçet's disease is uncommon but can be severe.
• Acute coronary syndromes are a potential manifestation of Behçet's disease.

Observation:

• A young male patient with Behçet's disease presented with acute coronary insufficiency.
• Coronary arteriography identified two coronary aneurysms and significant stenosis in the left anterior descending (LAD) artery.
• The patient experienced immediate relief of chest pain and ST segment changes after successful balloon angioplasty of the LAD stenosis.

Findings:

• Successful percutaneous coronary intervention (PCI) for LAD stenosis led to favorable short-term outcomes, including limited myocardial infarction.
• Surgical intervention was performed due to the risk of aneurysm rupture and hemopericardium.
• Histopathological examination confirmed destructive arterial lesions characteristic of Behçet's disease, involving false aneurysms in the LAD and left circumflex arteries.

Implications:

• This case highlights the importance of considering Behçet's disease in young patients presenting with acute coronary syndromes.
• Percutaneous coronary intervention can be a viable option for managing acute coronary stenosis in Behçet's disease.
• Aggressive management, including potential surgical intervention, is crucial for addressing complex coronary artery pathology in Behçet's disease to prevent life-threatening complications.