Double coronary thrombosis in a patient with Behçet's disease

Behçet's disease is a chronic relapsing multisystem autoinflammatory condition, in which cardiac involvement is rare, but among the most life-threatening complications. Treatment is largely empirical, and is aimed at suppressing vasculitis. In this role glucocorticoids and colchicine are freque...

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Bibliographic Details
Main Authors: Luís Abreu, Bruno Marmelo, Júlio Gil, Hugo Antunes, Maria Luísa Gonçalves, Pedro Ferreira, Emanuel Correia, Costa Cabral
Format: Article
Language:English
Published: Elsevier 2020-07-01
Series:Revista Portuguesa de Cardiologia
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Online Access:http://www.sciencedirect.com/science/article/pii/S0870255120302687
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Summary:Behçet's disease is a chronic relapsing multisystem autoinflammatory condition, in which cardiac involvement is rare, but among the most life-threatening complications. Treatment is largely empirical, and is aimed at suppressing vasculitis. In this role glucocorticoids and colchicine are frequently used.We present the case of a 42-year-old male with previously diagnosed Behçet's disease presenting to our emergency department with an anterior-inferior STEMI. He presented combined thrombosis of the distal anterior descending coronary artery and proximal right coronary artery, and was treated with sequential primary percutaneous coronary interventions and implantation of drug-eluting stents, but required two interventions due to high thrombotic load.His clinical course during hospitalization was good, with no systolic dysfunction at discharge. During follow-up, he has so far had no new cardiovascular events. Resumo: A doença de Behçet (BD) é uma doença autoimune crónica e recidivante, na qual o envolvimento cardíaco é muito raro, mas encontra-se entre as complicações fatais. O tratamento é em grande parte empírico e destina-se a suprimir a vasculite. Nesse papel, os glicocorticoides e a colchicina são frequentemente utilizados.Apresentamos o caso de um homem de 42 anos, com diagnóstico prévio de doença de Behçet que recorreu ao nosso serviço de emergência com STEMI anteroinferior. Apresentou trombose simultânea da artéria coronária descendente anterior distal e da artéria coronária direita proximal e foi tratada com intervenção coronária percutânea primária com stent revestido de drogas de forma sequencial, mas necessitando de duas intervenções devido à recorrência trombótica.Teve boa evolução clínica durante o internamento, não apresentando disfunção sistólica na alta. Durante o seguimento, até à data, não ocorreu novo evento cardiovascular.
ISSN:0870-2551