Heart 1999;81:214-217 ( February )
Case report
Giant aneurysm of the left main coronary artery in Takayasu
aortitis
Department of
Cardiology, Juntendo University School of Medicine, 2-1-1 Hongo,
Bunkyo-ku, Tokyo, 113-8421, Japan
Correspondence to: Dr Suzuki. email: hisuzuki{at}med.juntendo.ac.jp
Accepted for publication 8 June 1998
Takayasu aortitis is a chronic inflammatory vasculitis
characterised by stenosis or obliteration of large and medium sized arteries. Although coronary arteries are affected in approximately 10%
of cases, most of the lesions are luminal narrowing, and coronary aneurysm formation is extremely rare. A case is described of giant aneurysm of the left main coronary artery complicated with Takayasu aortitis in a 46 year old Japanese woman who was followed until her
death at age 71. Pronounced intimal proliferation and adventitial fibrous thickening of the involved arterial wall usually induce constriction or occlusion at the orifice of the main branch of the
aorta in Takayasu aortitis. However, systemic hypertension, which
resulted from renovascular stenoses in this case, is likely to have
enlarged the vessel lumen before replacement of medial and adventitial
fibrosis after extensive destruction of medial elastic fibres in the
left main coronary artery. Moreover, associations such as autoimmune
hepatitis, chronic thyroiditis, and Sjögren syndrome strongly
suggests that Takayasu aortitis may be an autoimmune disease.
© 1999 by Heart
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