HAL Id: hal-00571366
https://hal.archives-ouvertes.fr/hal-00571366
Submitted on 1 Mar 2011
HAL is a multi-disciplinary open access archive for the deposit and dissemination of sci- entific research documents, whether they are pub- lished or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers.
L’archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d’enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.
Images in vascular medicine
James J. Jang, Peter D. Gorevic, Jeffrey W. Olin
To cite this version:
James J. Jang, Peter D. Gorevic, Jeffrey W. Olin. Images in vascular medicine. Vascular Medicine,
SAGE Publications, 2007, 12 (4), pp.379-379. �10.1177/1358863X07083176�. �hal-00571366�
Vascular Medicine 2007; 12: 379
A 75-year-old woman presented with progressive chest pain and bilateral shoulder and arm pain. On presenta- tion, the patient had pulmonary edema and an elevated troponin I of 3.1 ng/ml (0.0–0.4 ng/ml). Additional blood tests revealed a C-reactive protein (CRP) level of 115.0 mg/l (0.0–8.0 mg/l). Subsequently, an erythrocyte sedimentation rate (ESR) was measured and was 95 mm/h (0–20 mm/h).
Coronary angiography was performed and revealed a tapered smooth narrowing (typical of giant cell arteritis) of the left anterior descending coronary artery (arrow, Panel A). The remaining coronary arteries were normal.
She underwent percutaneous angioplasty and stent implantation. After the coronary intervention, the patient had resolution of her chest pain; however, she continued to complain of exertional bilateral shoulder pain and arm discomfort when brushing her hair and writing.
Color duplex ultrasonography of the upper extremity arteries revealed severe long segment narrowing of bilateral subclavian arteries with extensive wall thicken- ing (arrow) that was diagnostic of giant cell arteritis (Panel B). Computed tomographic angiography demon- strated bilateral subclavian artery occlusions (arrows, Panel C). The patient was administered oral prednisone 60 mg daily with normalization of the ESR and CRP levels and improvement in her symptoms.
© 2007 SAGE Publications 10.1177/1358863x07083176
Los Angeles, London, New Delhi and Singapore
Images in vascular medicine
Giant cell arteritis presenting with acute myocardial infarction
James J Janga, Peter D Gorevicband Jeffrey W Olina
aZena and Michael A Wiener Cardiovascular Institute and Marie- Josée and Henry R Kravis Center for Cardiovascular Health, Mount Sinai School of Medicine and bDivision of Rheumatology, Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA
Address for correspondence: James J Jang, Division of Cardiology, Kaiser Permanente, Santa Teresa Medical Center, 270 International Circle, 2-North, 2nd Floor, San Jose, CA 95119, USA. Tel:⫹1 408 972 3410; Fax:⫹1 408 972 7158;
E-mail: james.j.jang@kp.org
