Coronary Arteritis and Pseudoaneurysm in Behçet's Disease: A Rare Cause of Myocardial Infarction ☆

The patient was a 32 year old male of Moroccan origin, diagnosed with Behcet’s disease 2 years earlier after suffering cerebral venous thrombosis. During that episode, oral and painful genital ulcers had appeared and oral anticoagulation with acenocoumarol was started. He came to the emergency room due to persistent and oppressive chest pain with ST segment elevation in the precordial leads, so we decided to perform emergency coronary angiography which revealed the existence of a stenosis of the distal left main coronary artery, which communicated through a narrow passage with a cavity which in turn compressed the proximal left anterior descending artery, occluding it (Fig. 1A and B). The patient underwent urgent cardiac surgery, demonstrating the presence of a pseudoaneurysm with fresh thrombi inside (Fig. 1C and D). CABG was performed with off-pump mammary arteries. Currently, the patient has moderate left ventricular systolic dysfunction and is in functional class II of the New York Heart Association.