Coronary Angiitis and Cardiac Arrest in Antineutrophil Cytoplasmic-Antibody Associated Systemic Vasculitis

Abstract

A 58-year-old man was admitted with a 6-week history of fever, lethargy, arthralgia, and dyspnea on exertion. He had no prior illness or cardiovascular risk factors, and with the exception of a pyrexia, his physical examination was unremarkable. Investigations were performed, including blood and urine cultures and a connective tissue screen. He was subsequently discharged with a view to an early outpatient review when he collapsed at home with cardiac arrest. The initial rhythm was ventricular fibrillation, which was successfully cardioverted. His postarrest electrocardiogram revealed transient right bundle-branch block and his plasma troponin I concentration was raised at 8.5 μg/L. His renal function was normal, but markers of …