Key result
Takayasu arteritis can manifest as sudden cardiac arrest in young adults from severe triple-vessel CAD.
Why the study?
Sudden cardiac arrest is rare in young individuals and typically caused by inherited cardiomyopathies or electrical disorders, but less common aetiologies should not be overlooked.
Takayasu arteritis can rarely present as sudden cardiac arrest due to coronary involvement in young adults, requiring a high index of clinical suspicion and histopathological evaluation.
Answers are grounded in this paper and cite their sources.
Warrants high suspicion for Takayasu arteritis in young sudden cardiac arrest patients with multivessel CAD; extends coronary spectrum and supports histopathology.
Background Sudden cardiac arrest (SCA) is rare in young individuals, being typically caused by inherited cardiomyopathies or electrical disorders. However, less common aetiologies should not be overlooked. Case Summary A male in his twenties suffered an aborted SCA. Initial investigations revealed significant triple-vessel coronary artery disease leading to urgent surgical revascularization. Macroscopically, diffuse coronary luminal narrowing due to marked wall thickening was observed. Histopathology of right internal mammary artery showed a non-necrotizing vasculitis pattern, which together with abdominal aorta, mesenteric and iliac artery involvement on computed tomography angiography supported a diagnosis of Takayasu arteritis. High-dose glucocorticoids were started, resulting in rapid normalization of inflammatory biomarkers. The patient was discharged after 54 days, with programmed administration of anti-tumour necrosis factor-alpha monoclonal antibody adalimumab. Conclusion Takayasu arteritis is a rare vasculitis classically affecting medium to large size vessels, but may involve the coronary tree and ultimately manifest as SCA. This case underscores the diagnostic challenges of young adults presenting with acute coronary syndromes, highlighting the importance of clinical suspicion, histopathological evaluation and a collaborative approach for a successful outcome.
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Correia et al. (2026) studied this question. Takayasu arteritis can involve the coronary tree and initially manifest as sudden cardiac arrest in young adults due to severe triple-vessel coronary artery disease.
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