Frontiers in Cardiovascular Medicine (Sep 2022)

Myocardial infarction with non-obstructive coronary arteries in a patient double-seropositive for anti-glomerular basement membrane and anti-neutrophil cytoplasmic antibodies: A case report

  • Marcell Krall,
  • Johannes Gollmer,
  • Marion J. Pollheimer,
  • Clemens Reiter,
  • Michael Kolland,
  • Alexander H. Kirsch,
  • Andreas Kronbichler,
  • Kathrin Eller,
  • Alexander R. Rosenkranz,
  • Balazs Odler

DOI
https://doi.org/10.3389/fcvm.2022.893742
Journal volume & issue
Vol. 9

Abstract

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We report a case of a patient double-seropositive for anti-glomerular basement membrane (anti-GBM) and anti-neutrophil cytoplasmic antibodies (ANCA) who reported retrosternal chest pain during a regular hemodialysis session associated with ST-segment depression in electrocardiogram and an increase of serum high-sensitivity troponin T. Urgent coronary angiography excluded obstructive coronary artery disease, suggesting the diagnosis of ischemia with non-obstructive coronary arteries. This case illustrates an unusual presentation of cardiovascular involvement in a patient with double-positive ANCA/anti-GBM disease, emphasizing the possible relevance of coronary microvascular dysfunction and the need for close cardiovascular follow-up in this patient population.

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