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Isolation of Valvular Endothelial Cells
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Isolated Antineutrophil Cytoplasmic Antibody-Associated Coronary Vasculitis and Valvulitis

Yoon Kook Kim1, Praveen Chekka1, Manu Mysore1

  • 1Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

A young woman experienced severe chest pain due to coronary artery stenosis. Vasculitis affecting the coronary arteries and aorta was diagnosed, leading to immunotherapy and bypass surgery.

Area of Science:

  • Cardiology
  • Immunology
  • Radiology

Background:

  • Coronary artery disease (CAD) can manifest with diverse etiologies.
  • Vasculitis is an inflammatory condition affecting blood vessels.

Observation:

  • A 30-year-old woman presented with angina pectoris.
  • Coronary angiography showed severe stenosis in the left main and right coronary arteries unresponsive to nitroglycerin.
  • Coronary CT angiography and PET revealed inflammation of the coronary ostia and aortic root fat stranding.

Findings:

  • The patient was diagnosed with vasculitis and valvulitis.
  • Inflammatory markers and imaging suggested an autoimmune or inflammatory process affecting the aorta and coronary arteries.

Implications:

  • This case highlights vasculitis as a potential cause of severe coronary artery stenosis in young adults.
  • Early diagnosis and multimodal imaging are crucial for identifying and managing non-atherosclerotic causes of CAD.
  • Treatment involved immunotherapy and surgical intervention (coronary bypass).

Keywords:
AAV, ANCA associated vasculitisANCA, antineutrophil cytoplasmic antibodyCABG, coronary artery bypass graftingCTA, computed tomography angiographyFDG, fluorodeoxyglucoseLMCA, left main coronary arteryMPA, microscopic polyangiitisMRA, magnetic resonance angiographyPET, positron emission tomographyRCA, right coronary arteryaortic valveautoimmunecoronary artery bypassvascular disease

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