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eISSN: 2084-9834
ISSN: 0034-6233
Reumatologia/Rheumatology
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4/2019
vol. 57
 
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abstract:
Case report

Acute coronary syndrome leading to revision of a co-morbid condition in a young man with arthritis

Svitlana Smiyan
1
,
Roman Komorovsky
1
,
Nazarij Tomashchuk
2

1.
2nd Department of Internal Medicine, Ivan Horbachevsky Ternopil National Medical University, Ukraine
2.
Department of Cardiac Surgery, Lviv Regional Hospital, Ukraine
Reumatologia 2019; 57, 4: 243-248
Online publish date: 2019/08/31
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Although patients with rheumatoid arthritis (RA) may have an increased incidence of cardiovascular events, the development of coronary artery disease and of myocardial infarction at young age is rather uncommon. Herein, we report a case of a 26-year-old man without classical cardiovascular risk factors, but with a 2-year history of RA, who experienced recurrent episodes of angina-like chest pain. His electrocardiogram showed ST-elevation and T-wave inversion in anterior chest leads, and the patient was sent for coronary angiography, which revealed multivessel coronary artery disease. Subsequently, the patient underwent coronary artery bypass grafting. Closer analysis of the patient’s history and of the laboratory findings led to revision of the diagnosis of RA: the patient was found to meet the classification criteria for systemic lupus erythematosus. Pitfalls of the classification criteria and the impact of the revised diagnosis on the patient’s care are discussed.
keywords:

rheumatoid arthritis, acute coronary syndrome, systemic lupus erythematosus, classification criteria







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