Skip to main content
SpringerLink
Log in

Acute Coronary Syndrome as a First Presentation of Systemic Lupus Erythematosus in a Teenager: Revascularization by Hybrid Coronary Artery Bypass Graft Surgery and Percutaneous Coronary Intervention: Case Report

  • Case Report
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

Patients with systemic lupus erythematosus (SLE) may present with acute coronary syndrome (ACS) due to coronary vasculitis or premature atherosclerosis. There is a paucity of data on invasive management strategies for young adults who present with an ACS secondary to active vasculitis. This article describes the case of a teenager who presented with an ACS secondary to lupus vasculitis as his first presentation of active SLE. Coronary angiography showed a left main equivalent lesion involving a proximal very large left anterior descending artery (LAD) and diagonal stenosis (with a diminutive left circumflex artery). The boy underwent a successful endoscopic coronary bypass surgery to his LAD followed by percutaneous coronary intervention to his diagonal artery. This case demonstrates the feasibility and safety of a hybrid coronary revascularization in a teenager with acute coronary syndrome due to coronary vasculitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Aldoboni AH, Hamza EA, Majdi K, et al. (2002) Spontaneous dissection of coronary artery treated by primary stenting as the first presentation of systemic lupus erythematosus. J Invasive Cardiol 14:694–696

    PubMed  Google Scholar 

  2. Dropinski J, Szczeklik W, Rubis P (2003) Cardiac involvement in systemic autoimmune disease. Pol Arch Med Wewn 109:375–381

    PubMed  Google Scholar 

  3. Ginzler EM, Schorn K (1988) Outcome and prognosis in systemic lupus erythematosus. Rheum Dis Clin North Am 14:67–78

    PubMed  CAS  Google Scholar 

  4. Haider YS, Roberts WC (1981) Coronary arterial disease in systemic lupus erythematosus: Quantification of degrees of narrowing in 22 necropsy patients (21 women) aged 16 to 37 years. Am J Med 70:775–781

    Article  PubMed  CAS  Google Scholar 

  5. Karrar A, Sequeira W, Block JA (2001) Coronary artery disease in systemic lupus erythematosus: A review of the literature. Semin Arthritis Rheum 30:436–443

    Article  PubMed  CAS  Google Scholar 

  6. Lagerqvist B, James SK, Stenestrand U, et al. (2007) Long-term outcomes with drug-eluting stents versus bare-metal stents in Sweden. N Engl J Med 356:1009–1019

    Article  PubMed  CAS  Google Scholar 

  7. Leclerc KM, Mascette AM, Schachter DT, Wicks AB (1999) Spontaneous coronary artery dissection in a young woman treated with extensive coronary stenting. J Invasive Cardiol 11:237–241

    PubMed  CAS  Google Scholar 

  8. Mandell BF (1987) Cardiovascular involvement in systemic lupus erythematosus. Semin Arthritis Rheum 17:126–141

    Article  PubMed  CAS  Google Scholar 

  9. Manzi S, Selzer F, Sutton-Tyrrell K, et al. (1999) Prevalence and risk factors of carotid plaque in women with systemic lupus erythematosus. Arthritis Rheum 42:51–60

    Article  PubMed  CAS  Google Scholar 

  10. Nanke Y, Kotake S, Shimamoto K, et al. (2000) Systemic lupus erythematosus with myocardial dysfunction due to microvasculopathy. Lupus 9:464–467

    Article  PubMed  CAS  Google Scholar 

  11. Sella EM, Sato EI, Leite WA, et al. (2003) Myocardial perfusion scintigraphy and coronary disease risk factors in systemic lupus erythematosus. Ann Rheum Dis 62:1066–1070

    Article  PubMed  CAS  Google Scholar 

  12. Spaulding C, Daemen J, Boersma E, et al. (2007) A pooled analysis of data comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med 356:989–997

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Emory University School of Medicine, 1639 Pierce Drive, WMB 319, Atlanta, GA, 30322, USA

    P. K. Mehta, H. Samady & W. M. Book

  2. Division of Cardiothoracic Surgery, Emory University School of Medicine, 1639 Pierce Drive, WMB 319, Atlanta, GA, 30322, USA

    T. A. Vassiliades

Authors
  1. P. K. Mehta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Samady
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. A. Vassiliades
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W. M. Book
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to P. K. Mehta.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mehta, P.K., Samady, H., Vassiliades, T.A. et al. Acute Coronary Syndrome as a First Presentation of Systemic Lupus Erythematosus in a Teenager: Revascularization by Hybrid Coronary Artery Bypass Graft Surgery and Percutaneous Coronary Intervention: Case Report. Pediatr Cardiol 29, 957–961 (2008). https://doi.org/10.1007/s00246-007-9157-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-007-9157-0

Keywords

Search

Navigation