Abstract
Behçet’s disease (BD) is a multisystemic chronic vasculitis characterized by its clinical polymorphism. It concerns mainly young men and generally appears between the third and the fourth decades. Cardiac involvement in Behçet’s disease is rare but represents a major prognostic factor. We report the case of a young man admitted in our department for the management of an acute coronary syndrome revealing a Behçet’s disease. Coronary angiography had shown a giant thrombosed aneurysm of the left coronary artery. Surgical treatment was successfully performed and the patient had a left anterior descending coronary artery bypass using the left internal mammary artery graft.
Highlights
First described in 1937, Behçet’s disease (BD) is defined as a chronic multisystemic inflammatory condition affecting small, medium and large-caliber vessels [1, 2]
Cardiac involvement in BD is uncommon, it is clearly associated with a poor prognosis [2]
We report the case of a young man admitted in our department for acute coronary syndrome secondary to a thrombosed aneurysm of the left anterior descending coronary artery and revealing an angiobehçet
Summary
First described in 1937, Behçet’s disease (BD) is defined as a chronic multisystemic inflammatory condition affecting small, medium and large-caliber vessels [1, 2]. A 32-year-old man, with no cardiovascular risk factors, was admitted in our department for typical chest pain that had been exaggerated in the last week In his past medical history, he had a left hip synovitis treated with corticosteroids and a recurrent oral aphthosis. He received antithrombotic therapy followed by a coronary angiography that showed multiple aneurysms of the main diagonal branch and the left circumflex coronary artery. We performed coronary angiography that showed a severe stenotic lesion of the proximal segment of the LAD localized opposite to a huge aneurysm of about 3 cm in size inducing a coronary steal phenomenon with a delayed opacification of the distality of the vessel (Figure 3). Surgeons proceeded to open and resect the aneurysm sutured the neck portion Afterward they performed a bypass of the LAD using the left internal mammary artery graft. The postoperative period went without incident and the patient was successfully discharged
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