Coronary Artery Vasculitis as a Substrate for Myocardial Infarction in a Patient With Systemic Lupus Erythematosus

A 26-year-old woman with a long history of systemic lupus erythematosus (SLE) presented with acute onset typical angina on rest. After being treated with anal-gesics, she arrived at the emergency department 21 hours later, normotensive and still with angina. Initial electrocardiogram (ECG) results showed an inferior ST-elevated myocardial infarction (STEMI) with extension to right precordial leads (Fig. 1). Coronary angiography showed left coronary artery ectasia with string-of-beads appearance and a total coronary occlusion of the right coronary artery (Fig. 2, A and B). No percutaneous coronary intervention (PCI) was per-formed. Here we present an atypical case of acute myocardial infarction caused by coronary artery vasculitis (CAV) in a patient with SLE.

Automated summary

A 26-year-old woman with a history of SLE presented with acute onset angina and was diagnosed with an inferior STEMI and right coronary artery occlusion. Coronary angiography revealed left coronary artery ectasia and no PCI was performed. This is a case of acute myocardial infarction caused by CAV in a patient with SLE.