Unstable angina secondary to left main coronary artery vasculitis as a rare initial manifestation of systemic lupus erythematosus. A case report.

ABSTRACT

We present the case of a woman in her third decade of life, known to have difficult-to-control mixed headaches and polycystic ovary syndrome, under hormonal treatment. Without any other manifestation, the patient debuted with an acute coronary syndrome classified as unstable angina. Electrocardiogram showed anterior and lateral ST segment depression and ST elevation in aVR. Coronary computer tomography and coronary angiography showed evidence of significant obstruction of the left main coronary artery. The patient was diagnosed with systemic lupus erythematosus (SLE), and was classified as vasculitis secondary to SLE as an unusual initial manifestation.

RESUMEN

Se presenta el caso de una mujer en la tercera década de la vida, con cefalea mixta de difícil control y síndrome de ovario poliquístico bajo tratamiento hormonal, sin ninguna otra manifestación, la cual debutó con un síndrome coronario agudo tipo angina inestable. El electrocardiograma mostró infradesnivel en cara anterior y lateral, así como supradesnivel del ST en aVR. La angiotomografia de coronarias y la coronariografía mostraron evidencia de obstrucción importante del tronco de la coronaria izquierda. Tras el abordaje se llegó al diagnóstico de vasculitis secundaria a lupus eritematoso sistémico como manifestación inicial poco habitual.