Document Detail

[Acute coronary syndrom as a cardiac manifestation of granulomatosis with polyangiitis].
MedLine Citation:
PMID:  23340944     Owner:  NLM     Status:  MEDLINE    
HISTORY AND ADMISSION FINDINGS: A 49-year-old patient was admitted to our ward because of a troponin elevation (non ST-elevation myocardial infarction) following a rhinoscopy in an external hospital. The patient complained of typical angina, chronic rhinitis and epistaxis. Analysis of the nasal biopsy had shown the histological finding of granulomatosis with polyangiitis (Wegener's granulomatosis).
INVESTIGATION: The consecutively performed catheterization showed a coronary one-vessel disease without significant stenosis. Echocardiography showed diastolic dysfunction as well as hemodynamically not significant pericardial effusion. The MRI scan of the heart revealed multiple myocardial scars located ventricular apical and septal. Extended bilateral pulmonary opacities in the thoracic CT scan, microhematuria, leukocyturia and proteinuria indicated multi-organ involvement of the small vessel disease.
TREATMENT AND COURSE: The patient's condition improved quickly in response to steroids and cyclophosphamide, followed by attenuation of clinical symptoms and normalizing blood and renal parameters.
CONCLUSION: The prognosis of granulomatosis with polyangiitis is mainly limited by renal and pulmonal involvement. Cardiac involvement is commonly rare and associated with clinical courses refractory to immunosuppressive therapy. Generally, all cardiac structures can be affected, thereby impending serious cardiac events. Normally, granulomatosis with polyangiitis responds quickly to immunosuppressive therapy, associated with a rather good prognosis without higher mortality.
T Asdonk; V Tiyerili; J Dörner; D Thomas; C Schaefer; D Skowasch; G Nickenig; S Pabst
Publication Detail:
Type:  Case Reports; English Abstract; Journal Article     Date:  2013-01-22
Journal Detail:
Title:  Deutsche medizinische Wochenschrift (1946)     Volume:  138     ISSN:  1439-4413     ISO Abbreviation:  Dtsch. Med. Wochenschr.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-23     Completed Date:  2013-03-18     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  0006723     Medline TA:  Dtsch Med Wochenschr     Country:  Germany    
Other Details:
Languages:  ger     Pagination:  213-7     Citation Subset:  IM    
Copyright Information:
© Georg Thieme Verlag KG Stuttgart · New York.
Vernacular Title:
Akutes Koronarsyndrom als kardiale Manifestation einer Granulomatose mit Polyangiitis.
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MeSH Terms
Acute Coronary Syndrome / diagnosis,  drug therapy,  etiology*
Cyclophosphamide / therapeutic use
Microscopic Polyangiitis / complications*,  diagnosis,  drug therapy
Middle Aged
Steroids / therapeutic use
Treatment Outcome
Vasculitis, Central Nervous System / complications*,  diagnosis,  drug therapy
Reg. No./Substance:
0/Steroids; 8N3DW7272P/Cyclophosphamide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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