open access

Vol 14, No 1 (2019)
Case Reports
Published online: 2019-04-10
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Juvenile Takayasu’s arteritis presenting as acute coronary syndrome in a 10 year-old girl

Santosh Kumar Sinha, Dibbendhu Khanra, Lokendra Rekwal, Puneet Aggarwal, Chandra Mohan Varma, Vinay Krishna
DOI: 10.5603/FC.2019.0012
·
Folia Cardiologica 2019;14(1):79-82.

open access

Vol 14, No 1 (2019)
Case Reports
Published online: 2019-04-10

Abstract

A 10 year-old girl was admitted to hospital for evaluation of sudden onset chest pain of three days’ duration. There were no co-morbidities or family history of coronary artery disease. There was a disparity of blood pressure in the upper limbs, while pulses in the lower limbs were barely palpable. Her electrocardiogram revealed ST segment elevation in II, III, and aVF leads. Laboratory tests showed elevated troponin T (0.8 ng/mL), total leukocyte count (13,800/μL), C-reactive protein (94 mg/L), and erythrocyte sedimentation rate (56 mm in first hr). Echocardiography showed mildly impaired left ventricular systolic function with an ejection fraction of 58%. Aortogram showed total occlusion of the brachiocephalic trunk, diffuse thoraco-abdominal coarctation, and osteo-proximal stenosis (80%) of the left renal artery. Coronary angiography revealed total occlusion of the left circumflex artery and tubular lesion of the proximal left anterior descending artery with 70% stenosis. Based on these findings, she was diagnosed to be in the active phase of juvenile Takayasu’s arteritis having acute inferior wall myocardial infarction. Her treadmill test for reversible ischaemia (modified Bruce protocol) was negative, and she was discharged on medication (antiplatelets, corticosteroids, and immunosuppressive agents). 

Abstract

A 10 year-old girl was admitted to hospital for evaluation of sudden onset chest pain of three days’ duration. There were no co-morbidities or family history of coronary artery disease. There was a disparity of blood pressure in the upper limbs, while pulses in the lower limbs were barely palpable. Her electrocardiogram revealed ST segment elevation in II, III, and aVF leads. Laboratory tests showed elevated troponin T (0.8 ng/mL), total leukocyte count (13,800/μL), C-reactive protein (94 mg/L), and erythrocyte sedimentation rate (56 mm in first hr). Echocardiography showed mildly impaired left ventricular systolic function with an ejection fraction of 58%. Aortogram showed total occlusion of the brachiocephalic trunk, diffuse thoraco-abdominal coarctation, and osteo-proximal stenosis (80%) of the left renal artery. Coronary angiography revealed total occlusion of the left circumflex artery and tubular lesion of the proximal left anterior descending artery with 70% stenosis. Based on these findings, she was diagnosed to be in the active phase of juvenile Takayasu’s arteritis having acute inferior wall myocardial infarction. Her treadmill test for reversible ischaemia (modified Bruce protocol) was negative, and she was discharged on medication (antiplatelets, corticosteroids, and immunosuppressive agents). 

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Keywords

juvenile Takayasu’s arteritis; acute coronary syndrome; diffuse coarctation

About this article
Title

Juvenile Takayasu’s arteritis presenting as acute coronary syndrome in a 10 year-old girl

Journal

Folia Cardiologica

Issue

Vol 14, No 1 (2019)

Pages

79-82

Published online

2019-04-10

DOI

10.5603/FC.2019.0012

Bibliographic record

Folia Cardiologica 2019;14(1):79-82.

Keywords

juvenile Takayasu’s arteritis
acute coronary syndrome
diffuse coarctation

Authors

Santosh Kumar Sinha
Dibbendhu Khanra
Lokendra Rekwal
Puneet Aggarwal
Chandra Mohan Varma
Vinay Krishna

References (7)
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