CORONARY ARTERY ANEURYSM IN A PATIENT WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Systemic lupus erythematosus is an autoimmune inflammatory disease of unknown etiology, the coronary lesions are extremely rare, and in particular the coronary aneurysms. We report a case of a coronary aneurysm of a patient diagnosed with Systemic lupus erythematosus who showed up at the emergency department suffering from a retro-sternal pain radiating to the jaws which he reported for 4 hours. An electrocardiogram was performed urgently and showed an offset of 2 mm in the inferior, right, basal and low lateral territories with a mirror V1, V2. The patient underwent coronary angiography which revealed an aneurysmal dilatation of the right coronary artery with multiple atheromatous aneurysms of different sizes without thrombi visualized in the lumen of the arteries. Coronary aneurysms are a fatal and has potentially fatal complications that should be considered in the diagnostic of systemic lupus erythematosus patients with cardiac symptoms as early detection may allow complete healing.

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Myocardial Infarction in Systemic Lupus Erythematosus – the Sex Specific Risk Profile

Current Pharmaceutical Design ◽

10.2174/1381612826666201210110809 ◽

2020 ◽

Vol 26 ◽

Author(s):

Marija Vavlukis ◽

Daniela Pop-Gjorceva ◽

Lidija Poposka ◽

Emilija Sandevska ◽

Sasko Kedev

Keyword(s):

Myocardial Infarction ◽

Systemic Lupus Erythematosus ◽

Cardiovascular Risk ◽

Coronary Artery ◽

Young Women ◽

Lupus Erythematosus ◽

Molecular Mechanisms ◽

Clinical Presentation ◽

Systemic Lupus ◽

Antiinflammatory Therapy

Background: Accelerated atherosclerosis is widely present in patients with systemic lupus erythematosus. Objective: The aim of this review is to analyze the relationship between systemic lupus erythematosus and cardiovascular diseases, with the emphasis on acute myocardial infarction. Results: Various molecular mechanisms triggered by infection/inflammation are responsible for endothelial dysfunction and development of atherosclerosis at an earlier age. Contributing factor is the cumulative effect of traditional cardiovascular risk factors interaction with disease related characteristics. Myocardial infarction rates are 2- to 10-fold higher compared to the general population. Young women have the highest relative risk, however, men carry at least 3- fold higher risk than women. Coronary involvement varies from normal coronary artery with thrombosis, coronary microartery vasculitis, coronary arteritis, and coronary atherosclerosis. Typical clinical presentation is observed in men and older women, while atypical is more frequent in young women. Treatment is guided by the underlying mechanism, engaging invasive procedures alone, or accompanied with immunosuppressive and/or antiinflammatory therapy. There are significant gender differences in pathophysiology and clinical presentation. However, they receive the same therapeutic treatments. Conclusion: Systemic lupus erythematosus is a major contributor to atherosclerotic and non-atherosclerotic mechanisms involved in the development of myocardial infarction, which should be taken into account during therapeutic treatment. Although Systemic lupus erythematosus per se is a “female” disease, males are at increased cardiovascular risk and worse outcome. Method: We conducted a literature review through PubMed and Cochrane, using key words: SLE, atherosclerosis, atherothrombosis, coronary artery disease, myocardial infarction, prognosis, sex specifics.

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