Acute Myocardial Infarction Secondary to Triple Coronary Arteries Dissection in a Patient With Takayasu Vasculitis

Figures

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  Figure 1. Electrocardiogram at Presentation Electrocardiogram showed sinus tachycardia with a heart rate of 120 beats/min, ST-segment elevation in leads II, III, and aVF along with reciprocal changes in leads I and aVL.

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  Figure 2. Coronary Angiogram Right anterior oblique cranial view of the left system revealed spontaneous coronary dissection in mid to distal left anterior descending coronary artery and diagonal 2 (D2).

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  Figure 3. Coronary Angiogram Anteroposterior caudal view revealed a large filling defect from the proximal to distal left circumflex artery secondary to spontaneous artery dissection.

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  Figure 4. Coronary Angiogram Left anterior oblique cranial view of right coronary artery revealed longitudinal filling defects in mid to distal involving acute marginal branch secondary to spontaneous coronary artery.

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  Figure 5. Computed Tomography Aortic Angiogram Findings were consistent with large vessel vasculitis, mainly Takayasu arteritis. Oblique sagittal maximum intensity projection image of the aortic arch showed focal eccentric mural thickening of the proximal left subclavian artery causing mild stenosis.

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  Figure 6. Coronal Maximum Intensity Projection Image Image of the abdominal aorta showed circumferential mural thickening of the proximal right renal artery and lower moiety left renal artery causing severe stenosis.

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  Figure 7. Sagittal Maximum Intensity Projection Image Image of the abdominal aorta circumferential mural thickening of the proximal superior mesenteric artery causing severe stenosis.