RESUMO
We report a 13-year-old girl diagnosed with systemic lupus erythematosus (SLE) who presented with left-sided chest pain, with ECG changes and elevation troponins that were suggestive of an acute inferior wall myocardial infarction (MI). Her multi-slice computed tomography coronary angiogram and standard angiogram were normal. The cardiac magnetic resonance imaging revealed an area of infarcted myocardium that was in the right coronary artery territory. We believe her MI was most likely secondary to coronary vasospasm. MI is rare and coronary vasospasm is an uncommon cause of MI in children and adolescents with SLE.
Assuntos
Vasoespasmo Coronário/complicações , Lúpus Eritematoso Sistêmico/complicações , Infarto do Miocárdio/etiologia , Adolescente , Dor no Peito/etiologia , Angiografia Coronária , Vasos Coronários/patologia , Ecocardiografia , Feminino , Humanos , Tomografia Computadorizada Multidetectores , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/fisiopatologiaRESUMO
Permanent complete heart block (CHB) secondary to the loss of first septal perforator after percutaneous coronary intervention (PCI) of the left descending artery (LAD) is an extremely rare complication. We describe a case report where a patient underwent PCI of proximal LAD, complicated by loss of first septal perforator, septal infarction, and bifasicular block, which progressed to symptomatic delayed CHB. One week later, the patient required implantation of a permanent pacemaker following failure to wean off the transvenous temporary pacing maker.