血管炎が原因と考えられた冠状動脈瘤内血栓からの塞栓により心筋梗塞を再発した若年者の1例

Repeated Myocardial Infarction due to Intraluminal Thrombus in a Coronary Aneurysm Suspected to be Caused by Vasculitis in a Young Male：Report of a Case

はじめに　冠状動脈瘤はまれな疾患であり，動脈硬化のほかに，川崎病以外の血管炎でも冠状動脈瘤を認めうる．われわれは，血管炎の既往を認めない若年者の冠状動脈瘤に対して手術加療を行い，冠状動脈瘤壁の病理組織検査で血管炎の所見を認めた1例を経験したので報告する．

Coronary artery aneurysms are rare and are often associated with atherosclerosis in adults and Kawasaki disease in children. Thromboembolism and rupture of the aneurysm are common complications associated with this condition. We report a case of coronary aneurysm resection and coronary artery bypass grafting （CABG） in a 36-year-old man with a history of recurrent acute myocardial infarction. There was no coronary aneurysms in first acute myocardial infarction. Histopathological examination of the resected coronary artery aneurysm wall revealed features of vasculitis, although the patient showed no episodes and physical findings of vasculitis. Coronary vasculitis can cause vascular endothelial cell injury and therefore requires careful follow-up.