Key result
IVUS and FFR identified Takayasu arteritis in a 25-year-old woman with MI, guiding a conservative strategy and immunosuppression that kept her asymptomatic at 2 months.
Why the study?
Myocardial infarction in young women can result from various nonatherosclerotic causes that are not always distinguishable on coronary angiography alone, requiring additional intravascular imaging.
Case Report (n=1)
Intravascular imaging and physiologic evaluation can identify nonatherosclerotic causes of MI, such as Takayasu arteritis, in young women and help avoid unnecessary coronary stenting.
BACKGROUND: Myocardial infarction (MI) in young women may result from vasospasm, spontaneous coronary artery dissection, vasculitis, or plaque rupture. These etiologies are not always distinguishable on coronary angiography alone, necessitating additional intravascular imaging. CASE SUMMARY: A 25-year-old woman presented with non-ST segment elevation MI and was found to have proximal left anterior descending artery occlusion. Intravascular ultrasound (IVUS) revealed features suggestive of Takayasu arteritis, which was confirmed through further work-up. Based on IVUS and fractional flow reserve (FFR) findings, stenting was deferred. She was started on immunosuppressive therapy and remained asymptomatic at 2-month follow-up. DISCUSSION: Multimodality assessment using IVUS together with physiologic evaluation by FFR was critical in identifying vasculitic changes and guiding a conservative interventional strategy. Long-term management focused on immunosuppression to control disease activity. TAKE-HOME MESSAGES: In young women with MI, nonatherosclerotic causes should be considered. IVUS and FFR can aid diagnosis and help avoid unnecessary coronary intervention.
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Karthikesan et al. (2026) conducted a case report in Non-ST segment elevation myocardial infarction (NSTEMI) secondary to Takayasu arteritis (n=1). IVUS and FFR-guided conservative strategy and immunosuppressive therapy was evaluated on Symptom status. IVUS and FFR identified Takayasu arteritis in a 25-year-old woman with MI, guiding a conservative strategy and immunosuppression that kept her asymptomatic at 2 months.
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