Ankilozan spondilitli hastada koroner arter ektazisi ve stenoz

Ankilozan spondilit, omurga ve sakroiliyak eklem tutulumu ile karakterize olan kronik inflamatuvar romatizmal bir hastalıktır. Ankilozan spondilit, extraartiküler dokulardan göz, sindirim sistemi, kalp ve böbrek tutulumu yapabilir ve asemptomatik seyirden yüksek kardiyovasküler morbidite ve mortaliteye kadar geniş bir yelpazede karşımıza çıkabilen kardiyovasküler komplikasyonlara sebep olabilmektedirler. Bu nedenle erken teşhis klinik olarak büyük önem arz eder. Angina sebebi ile hastanemize başvuran 53 yaşındaki kadın hastanın öyküsünde 16 yıldır anklozan spondilit ile dış merkezde takipli olduğu öğrenildi. Yapılan ekokardiyografide sol ventrikül duvar hareket bozukluğu ve hafif derecede mitral yetmezliği olduğu saptandı. Elektif yapılan koroner anjiyografide ektazik LADde koroner arter stenozu tespit edilen hastaya LIMA-LAD tek damar by-pass planlandı. Yazımızda ankilozan spondilit hastalığına sahip bir hastada koroner arter ektazisi ile birlikte koroner arter stenozu varlığında yapılan koroner revaskülarizasyon deneyimimizi aktarmayı amaçladık.

Coronary artery ectasia and stenosis in a patient with ankylosing spondylitis

The ankylosing spondilitis a chronic rheumatic inflammatory disorder characterized by the involvement of vertebrae and sacroiliac joints. It may attack eyes, alimentery system, heart and kidneys extraarticulary, and it can cause cardiovasculary complications in a range of an asymptomatic course to high morbidity and mortality. Hence a timely diagnosis is of prime clinical importance. A female patient of 53 years of age applied to our hospital with angina pectoris and her medical history revealed a 16 years of follow-up due to ankylosing spondilitis in another health institution. The echocardiography established a left ventricular wall motion abnormality and a mild mitral insufficiency. In the elective coronary angiography the ectatic LAD was detected to be stenozed and a LIMA single vessel by-pass was planned for this patient. In this report, we would like to enroll our experience of coronary revascularization on an ectatic coronary artery with stenosis in an ankylosing spondylosis patient.

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