AI Article Synopsis
- IgG4-related disease (IgG4-RD) is a new fibro-inflammatory condition affecting various organs, and it can lead to serious heart issues like IgG4-related coronary artery aneurysms (IGCAs).
- A 60-year-old man with a known history of IgG4-RD experienced acute coronary syndrome due to rapid progression of an IGCA and related artery blockages, necessitating multiple surgical interventions.
- Close monitoring with imaging techniques like CT scans is crucial for detecting any enlargement of IGCAs early to prevent life-threatening complications.
Article Abstract
Background: IgG4-related disease (IgG4-RD) is a recently recognized fibro-inflammatory disorder that can affect almost any organ. IgG4-RD has also been reported in coronary arteries as periarteritis. IgG4-related coronary periarteritis may cause coronary artery aneurysms, and IgG4-related coronary artery aneurysms (IGCAs) are life-threatening. We describe a case of a patient with IGCA that highlights the usefulness and limitations of various IGCA evaluation modalities and provides insight into disease pathophysiology.
Case Summary: A 60-year-old man with IgG4-RD diagnosed 2 years before and with IGCA at the proximal right coronary artery (RCA) on coronary angiography (CAG) 9 months prior to admission to the hospital presented with acute coronary syndrome. Emergent CAG revealed the rapid progression of IGCA at the RCA, an obstruction of the diagonal branch, and stenosis of the left anterior descending artery (LAD) and the high lateral branch (HL). The patient underwent percutaneous coronary intervention for the diagonal branch. The RCA aneurysm was resected and bypassed with a saphenous vein graft (SVG); coronary bypass grafting (left internal mammary artery to LAD and SVG to HL) was performed. Pathological findings showed inflammatory cell infiltration and disruption of the elastic plate.
Conclusion: IGCAs require careful follow-up with computed tomography scans for early detection of aneurysmal enlargement.
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| http://dx.doi.org/10.1016/j.carpath.2024.107647 | DOI Listing |
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