Skip to main content
SpringerLink
Log in

Disseminated multiple ostial stenoses in a young woman presenting as unstable angina

  • Case Report
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

A previously healthy 40-year-old woman presented as unstable angina. She had a family history of stroke as the only cardiovascular risk factor. Her blood pressure on admission was 150/90 mmHg. Laboratory study showed absolutely all negative markers of inflammation, autoimmune disorders, or atherosclerosis. Coronary angiography revealed subtotal ostial stenosis of the right coronary artery (RCA). Additionally, total occlusion of the ostium of the right subclavian artery and severe discrete ostial stenoses of left subclavian, celiac, superior mesenteric, both renal arteries were demonstrated on multidetector computed tomographic and magnetic resonance angiographies. She underwent stent implantation at the culprit lesion of RCA, and the left subclavian and both renal arteries. The fluorine-18-fluorodeoxyglucose positron-emission tomography-computed tomography showed slightly increased glucose metabolism at the proximal left subclavian artery. She is doing very well for 10 months during taking antiplatelet agents only.

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

References

  1. Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X (2007) Fibromuscular dysplasia. Orphanet J Rare Dis 2:28–35. doi:10.1186/1750-1172-2-28

    Article  PubMed  Google Scholar 

  2. Slovut DP, Olin JW (2004) Fibromuscular dysplasia. N Engl J Med 350:1862–1871. doi:10.1056/NEJMra032393

    Article  PubMed  CAS  Google Scholar 

  3. Maksimowicz-McKinnon K, Hoffman GS (2006) Takayasu’s arteritis. In: Creager MA, Dzau VJ, Loscalzo J (eds) Vascular medicine: a companion to Braunwald’s heart disease, 1st edn. Saunders, Philadelphia, pp 623–628

    Google Scholar 

  4. Numano F, Okawara M, Inomata H, Kobayashi Y (2000) Takayasu’s arteritis. Lancet 356:1023–1025. doi:10.1016/S0140-6736(00)02701-X

    Article  PubMed  CAS  Google Scholar 

  5. Endo M, Tomizawa Y, Nishida H, Aomi S, Nakazawa M, Tsurumi Y et al (2003) Angiographic findings and surgical treatments of coronary artery involvement in Takayasu arteritis. J Thorac Cardiovasc Surg 125:570–577. doi:10.1067/mtc.2003.39

    Article  PubMed  Google Scholar 

  6. Pate GE, Lowe R, Buller CE (2005) Fibromuscular dysplasia of the coronary and renal arteries? Catheter Cardiovasc Interv 64:138–145. doi:10.1002/ccd.20246

    Article  PubMed  Google Scholar 

  7. Safian RD (2003) Atherosclerotic renal artery stenosis. Curr Treat Options Cardiovasc Med 5:91–101. doi:10.1007/s11936-003-0017-9

    Article  PubMed  Google Scholar 

  8. Huizar JF, Awasthi A, Kozman H (2006) Fibromuscular dysplasia and acute myocardial infarction: evidence for a unique clinical and angiographic pattern. J Invasive Cardiol 18:e99–e101

    PubMed  Google Scholar 

  9. Innami R, Nagaoka H, Oonuki M, Manabe S (1999) Diffuse myocardial infarction caused by isolated bilateral coronary ostial stenosis in a young woman: report of a case. Surg Today 29:1120–1124. doi:10.1007/s005950050657

    Article  PubMed  CAS  Google Scholar 

  10. Subramanyan R, Joy J, Balakrischnan KG (1989) Natural history of aortoarteritis (Takayasu’s disease). Circulation 80:429–437

    PubMed  CAS  Google Scholar 

  11. Ziaee A, Herrmann SC, Lim MJ, Kern MJ (2005) Intravascular ultrasound and fractional flow reserve of equivocal left main stenosis in patients with Takayasu’s arteritis. Catheter Cardiovasc Interv 65:381–385. doi:10.1002/ccd.20390

    Article  PubMed  Google Scholar 

  12. Ahmadi-Simab K, Hellmich B, Holl-Ulrich K, Fleischmann C, Dourvos O, Gross WL (2007) Acute coronary syndrome in Takayasu arteritis without elevation of acute phase parameters. Rheumatology 46:554–555. doi:10.1093/rheumatology/kel392

    Article  PubMed  CAS  Google Scholar 

  13. Walter MA, Melzer RA, Schindler C, Müller-Brand J, Tyndall A, Nitzsche EU (2005) The value of 18F-FDG PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease. Eur J Nucl Med Mol Imaging 32:674–681. doi:10.1007/s00259-004-1757-9

    Article  PubMed  Google Scholar 

  14. Andrews J, Mason JC (2007) Takayasu’s arteritis—recent advances in imaging offer promise. Rheumatology 46:6–15. doi:10.1093/rheumatology/kel323

    Article  PubMed  CAS  Google Scholar 

  15. Naik N, Kothari SS, Sharma S (1999) Familial Takayasu’s aortoarteritis in two sisters. Indian Heart J 51:75–76

    PubMed  CAS  Google Scholar 

  16. Jeeva I, Sajid J, Ali O, Bonthron DT, Frossard PM (2007) Atypical Takayasu arteritis: a family with five affected siblings. Med Sci Monit 13:CS101–CS105

    PubMed  Google Scholar 

Download references

Conflict of interest statement

None.

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Chonbuk National University Medical School and Cardiovascular Center, 42 Wonjam-5-gil, Deokjin-gu, Chonju, Jeollabuk-do, 561-712, Republic of Korea

    Sun Hwa Lee, Jei Keon Chae & Jae Ki Ko

  2. Department of Nuclear Medicine, Chonbuk National University Medical School, Chonju, Republic of Korea

    Seok Tae Lim

Authors
  1. Sun Hwa Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jei Keon Chae
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Seok Tae Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jae Ki Ko
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jei Keon Chae.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, S.H., Chae, J.K., Lim, S.T. et al. Disseminated multiple ostial stenoses in a young woman presenting as unstable angina. Rheumatol Int 29, 693–697 (2009). https://doi.org/10.1007/s00296-008-0739-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-008-0739-9

Keywords

Search

Navigation