Takayasu's Arteritis: A Case Complicated with Acute Myocardial Infarction and Renovascular Hypertension

ABSTRACT

This report describes a 26-year-old man of Takayasu's arteritis complicated with acute myocardial infarction due to the occlusion of proximal left anterior descending artery and renovascular hypertension which was improved spontaneously without obstruction of stenotic renal artery. Coronary artery involvement and myocardial ischemic symptom in Takayasu's arteritis is uncommon and only about 10 case of acute myocardial infarction were reported. But most cases were diagnosed by autopsy after death. In this case, acute myocardial infarction developed during follow up after diagnosis of Takayasu's aortitis and coronary artery involvement was confirmed by coronary angingraphy. Hypertension is found in 40-70% of the cases. In our case hypertension was complicated and thought to be renovascular origin. It was refractory to medication including captopril. During follow up blood pressure was normalized spontaneously after wide fluctuations for 3 times. Now he is normotensive without medication. It is thought to give a new insight to the mechanism and treatment of renovascular hypertension.