Letter to the Editor
Acute myocardial infarction with normal coronary arteries in a young man with the Behcet's disease

https://doi.org/10.1016/j.ijcard.2003.11.039Get rights and content

Abstract

Behcet's disease (BD) is an inflammatory disorder of unknown origin, which usually presents with mucocutaneous, ocular, articular, vascular, gastrointestinal and central nervous system manifestations. Although cardiac involvement is not infrequent as a manifestation of Behcet's disease, coronary arteritis is very rarely reported. We suggest that the diagnosis of coronary arteritis should be considered in patients presenting acute myocardial infarction especially in young patients as underlying cause.

Introduction

Coronary artery disease is one of the most common causes of acute myocardial infarction [1]. In addition to atherosclerosis, coronary vasculitis may also cause the acute coronary syndromes [2], [3], [4]. One of the most common characteristics of Behcet's disease (BD) is vasculitis, which rarely involves the coronary arteries [5], [6], [7]. But data about clinical significance of coronary artery involvement is very limited. In Behcet's disease, acute myocardial infarction is a serious complication and an important clinical manifestation of coronary arteritis. Myocardial infarction due to coronary vasculitis in Behcet's disease is infrequent and documented in only a few cases in literature [2], [3], [4]. In this paper, we report a patient with Behcet's disease presenting acute myocardial infarction due to coronary vasculitis with normal coronary arteries.

Section snippets

Case

A 34-year-old male patient presented with chest pain located on epigastrium and retrosternal lasting for 2 h admitted to emergency department. Detailed past medical history revealed that he has no risk factors for coronary artery disease, and he had had been diagnosed as BD 7 years ago. He has not been taking medication for BD. On first examination in emergency department, blood pressure was 130/70 mm Hg and heart rate was 85 bpm. He was pale and sweated in appearance. On his chest

Discussion

Vascular involvement is the well-known characteristic of BD. It can occur even in young patients with no vascular risk factor. Especially, arterial involvement is expressed by thrombosis, stenosis, and/or aneurysms, as shown in early studies [2], [3], [4], [5], [6], [7]. The thrombosis associated with BD may be due to vascular endothelial cellular dysfunction and/or a reduction of systemic fibrinolytic activity and a rise in fibrinogen and factor VIII, but the precise mechanism of thrombosis is

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