Sudden death complicating a coronary arteritis: polyarteritis nodosa (case report)

Area of Science:

• Cardiology
• Rheumatology
• Vascular Medicine

Background:

• Coronary artery aneurysms are rare, often linked to atherosclerosis.
• Optimal revascularization for acute myocardial infarction (AMI) in polyarteritis nodosa (PAN) remains unclear, with limited case report data.
• Polyarteritis nodosa (PAN) is a systemic vasculitis that can affect various organs, including the coronary arteries.

Observation:

• A young male patient with a history of PAN presented with acute myocardial infarction (AMI).
• Coronary angiography revealed multiple severe aneurysmal and stenotic changes in the coronary arteries.
• The clinical presentation and angiographic findings strongly suggested AMI as a complication of PAN-related vasculitis.

Findings:

• Acute myocardial infarction (AMI) occurred in a patient with polyarteritis nodosa (PAN), complicated by severe coronary artery aneurysms and stenosis.
• The case highlights the potential for significant coronary artery involvement in chronic PAN.
• The pathophysiology of AMI in PAN patients necessitates consideration of vasculitis as a primary cause.

Implications:

• Coronary artery involvement requires vigilant monitoring in patients with chronic PAN.
• Interventional strategies for AMI in PAN patients must be guided by specific angiographic findings to mitigate risks.
• This case underscores the importance of considering vasculitis in the differential diagnosis of myocardial infarction, especially in patients with systemic inflammatory conditions.