Korean Circ J.  2012 Aug;42(8):568-570. 10.4070/kcj.2012.42.8.568.

Polyarteritis Nodosa Complicated by Chronic Total Occlusion Accompanying Aneurysms on All Coronary Arteries

• Chung DC
• Choi JE
• Song YK
• Lim AL
• Park KH
• Choi YJ

• KMID: 2225009
• DOI: http://doi.org/10.4070/kcj.2012.42.8.568

Abstract

Polyarteritis nodosa (PAN) is characterized by inflammatory necrosis of medium sized arteries. PAN can also be associated with stenosis or aneurysm of the coronary artery. However, the involvement of PAN at a coronary artery is usually asymptomatic, which makes it difficult to diagnose. In addition, all of the three main coronary arteries involved with chronic total occlusion (CTO) is a rare finding in patients with PAN. We report a patient that presented with PAN complicated by CTO and aneurysms of three main coronary arteries, without typical symptoms of angina.

Keyword

Polyarteritis nodosa; Coronary aneurysm; Coronary occlusion

MeSH Terms

Aneurysm
Arteries
Constriction, Pathologic
Coronary Aneurysm
Coronary Occlusion
Coronary Vessels
Humans
Necrosis
Polyarteritis Nodosa

Figure

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  Fig. 1 The upper extremity angiography showed aneurismal change with distal total occlusion of the left axillary artery (A) and multiple aneurismal changes in the right axillary and brachial arteries (B).

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  Fig. 2 Medium sized artery showed inflammation at low magnification (×100). The inflammation is especially severe in the intima and the lumen was nearly obstructed.

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  Fig. 3 The left coronary artery angiography showed a huge aneurysm and chronic total occlusion (CTO) of the left anterior descending coronary artery and the left circumflex coronary artery (A). The right coronary artery angiography revealed a huge aneurysm in its proximal segment and CTO (B).

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