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Coronary artery vasospasm in a patient with Churg-Strauss syndrome


Patients with Churg-Strauss syndrome often suffer from unusual cardiac manifestations and sudden cardiac death. This differs from patients with other autoimmune disorders, who typically present with premature ischaemic heart disease. We report the case of a 56-year-old man with recurrent coronary vasospasm, including an inferoposterior ST-elevation myocardial infarction, complicated by bradycardic arrest. There was only minor coronary artery disease on coronary angiography. An elevated eosinophil count was noted. His medical history included allergic rhinitis with polyposis, adult-onset asthma and biopsy-proven eosinophilic oesophagitis. Review of his sinus biopsies demonstrated blood vessels with marked accumulation of eosinophils in extravascular areas. The patient, therefore, met the American College of Rheumatology criteria for Churg-Strauss syndrome. The patient was commenced on immunosuppression, with the return of the eosinophil count to within normal limits, and remains free of cardiovascular events over 24 months.

Type Journal
Authors Trivedi, S.J.;Tanous, D.; Suan, D.
Responsible Garvan Author Dr Daniel Suan
Publisher Name BMJ Case Rep
Published Date 2018-10-25
Published Pages bcr-2018-225321
Status Always Electronic
DOI 10.1136/bcr-2018-225321
URL link to publisher's version