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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Giant left anterior descending artery aneurysm in a patient with active systemic lupus erythematosus: a case report

Zipeng Yao1, Yanhong Long1, Zheng Zong2

  • 1Department of Cardiology, The First People's Hospital of Tianmen, Tianmen, 431700, China.

Journal of Cardiothoracic Surgery
|November 22, 2021
PubMed

Insights

Systemic lupus erythematosus (SLE) patients require screening for coronary artery aneurysms (CAAs). Early detection and treatment with anticoagulation and antiplatelet therapy are crucial for managing this rare but serious condition.

Area of Science:

  • Cardiology
  • Rheumatology
  • Vascular Medicine

Background:

  • Coronary artery aneurysms (CAAs) are rare but can grow to giant sizes (>8 mm).
  • Systemic lupus erythematosus (SLE) is associated with autoantibody- and immune complex-mediated atherosclerosis, a common cause of CAAs in these patients.

Observation:

  • A 53-year-old female SLE patient presented with chest pain.
  • Coronary angiography revealed a giant aneurysm in the left anterior descending artery (LAD) and occlusion in the left circumflex artery (LCX).
  • Risk factors included abnormal pulmonary enzymes, dyslipidemia, and nephritis.

Findings:

  • Anticoagulation and antiplatelet therapy were initiated to prevent thromboembolism.
  • Stent implantation in the LCX restored TIMI grade III flow.
  • The patient's chest pain resolved, and she remained healthy during 6-month follow-up.

Implications:

  • This case highlights the importance of screening SLE patients for CAAs.
  • Prompt diagnosis and management, including anticoagulation and antiplatelet therapy, are essential for favorable outcomes in CAA patients with SLE.
Abstract

Keywords:
Coronary angiographyCoronary artery aneurysmSystemic lupus erythematosus

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