Chest pain and ST-segment elevation in a patient with polymyositis: a case report.

BACKGROUND: Cardiac involvement in patients with polymyositis is well-documented and includes myocarditis, coronary arteritis, pericarditis, valvular dysfunction and arrhythmias. CASE REPORT: There are only few reports of acute myocarditis in patients with polymyositis and, although it usually follows a chronic, mild course, it may occasionally become life-threatening. We describe the case of a 36-year-old young woman suffering from polymyositis who presented with clinical signs and symptoms mimicking an ST Elevation Acute Coronary Syndrome. The atypical features of the pain, the young age of the woman, the lack of significant cardiovascular risk factors and the medical history of an autoimmune disease, led us to reconsider our initial diagnosis towards the presence of focal myocarditis. CONCLUSION: We describe our diagnostic approach and comment on our speculations and decisions about the treatment of such a life threatening event.

Relation of coronary artery ectasia to diabetes mellitus.

An increased prevalence of coronary artery ectasia (CAE) and a low frequency of diabetes mellitus have been reported in patients with abdominal aortic aneurysm (AAA). The prevalence of diabetes was studied in 190 patients with CAE in comparison with 341 age- and gender-matched patients with coronary artery disease alone. Diabetes mellitus was found to be independently but inversely associated with CAE (relative risk 0.603, 95% confidence interval 0.375 to 0.960, p = 0.037), thus resembling the relation between diabetes and AAA.