An unusual cause of recurrent acute myocardial infarction

Abstract

Introduction: Behcet's disease is an inflammatory disorder of unknown origin, with mucocutaneous, ocular, articular, vascular, gastrointestinal and central nervous system manifestations. About 28 cases of myocardial infarction associated with Behcet's disease have been reported previously. Although coronary involvement is rare in Behcet's disease, it is especially important because it affects young individuals and often presents as acute coronary syndromes. Case presentation: A 22-year-old Tunisian man was admitted to our emergency department for retrosternal pain of two and a half hours duration. His detailed medical history revealed that he had no risk factors for coronary artery disease. His electrocardiogram showed anterior myocardial infarction. He underwent coronary angiography that showed constriction by 50% of the left anterior descending artery. When he was hospitalized one month later to evaluate this recent event, he developed clinical findings consistent with the diagnosis of Behcet's syndrome. Three months later, he experienced another episode of inferior myocardial infarction. Conclusion: This case highlights the importance of careful diagnostic work-up in the evaluation of myocardial infarction in patients. Although coronary involvement is rare in Behcet's disease, it is especially important because it affects young individuals and often presents as acute coronary syndromes.