Progressive coronary aneurysms in Behçet disease, a journey through surgical and percutaneous treatment: A case report

• Published in: Journal of cardiology cases Vol. 14; no. 1; pp. 32 - 34
• Main Authors: Husain, Aysha, MD, Al-Allaf, Abdalkareem, MD, AlAmri, Maha, MD, AlKalbani, Ahmed, MD
• Format: Journal Article
• Language: English
• Published: Japan Elsevier Ltd 01.07.2016; Japanese College of Cardiology
• Subjects: Aneurysms; Behçet disease; Cardiovascular; Coronary artery bypass graft; Coronary artery disease; Aneurysms; Coronary artery bypass graft; Behçet disease; Coronary artery disease
• ISSN: 1878-5409; 1878-5409
• DOI: 10.1016/j.jccase.2016.03.011

Abstract Behçet disease is a systemic autoimmune disease that causes inflammation within the vascular tree. Coronary arteries are rarely involved with stenosis, arteritis or aneurysm formation. Treatment is mainly directed to reduce the burden of inflammation systemically with steroid and immunosuppressive medications. However, patients might present in critical conditions requiring interventions in the form of percutaneous therapy or surgical bypass grafting. We present the case of a 34-year-old male who presented with acute coronary insult and was later found to have Behçet disease. His course was aggressive, as he required bypass graft surgery for rupture coronary aneurysm and cardiac tamponade. Later on, he required percutaneous intervention with cover stents for multiple coronary aneurysms that he developed afterward despite being on medical therapy. < Learning objective: Behçet disease is a rare cause of coronary aneurysms that present with acute coronary syndrome. The underlying etiology is related to inflammatory changes within the vessels. The main stay of treatment is medical therapy that suppresses the immune system. As these aneurysms are at risk of rupture, percutaneous interventions in the form of cover stents and bypass graft surgeries have been used with variable outcomes.>