ST Elevation Myocardial Infarction as Presenting Feature of C-ANCA Vasculitis: A Case of a Diagnostic Dilemma

• Published in: European journal of case reports in internal medicine Vol. 7; no. 8; p. 001658
• Main Authors: Museedi, Abdulrahman S, Nashawi, Mouhamed, Ghali, Abdullah, Hussein, Ali A, Saca, James
• Format: Journal Article
• Language: English
• Published: Italy SMC Media Srl 2020; SMC MEDIA SRL
• Subjects: c-anca; st elevation myocardial infarction; vasculitis; C-ANCA; ST elevation myocardial infarction; Vasculitis
• ISSN: 2284-2594; 2284-2594
• DOI: 10.12890/2020_001658

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS). Although uncommon, it should be included in the differential diagnosis for middle-aged patients without elevated atherosclerotic vascular disease risk or a family history of cardiovascular disease. SCAD is associated with postpartum women; however, reports noting its association with autoimmune disease and vasculopathy in other populations have recently gained prominence. We report a case of a 41-year-old male who was found to have SCAD after presenting with ST segment elevation myocardial infarction in the context of episodic vision loss, and who later underwent work-up for C-ANCA vasculitis and was successfully treated with corticosteroids. SCAD is most common in middle-aged females. However, it can present in male patients, and it should raise suspicion of underlying vasculopathy.Eosinophilic vasculitis may mimic parasitic infection.C-ANCA vasculitis can be associated with SCAD.