Acute coronary syndrome of very unusual etiology

We report a case of a 40‐year‐old male patient admitted with a clinical picture of acute coronary syndrome (unstable angina). He had no risk factors for coronary artery disease. The physical examination revealed nothing remarkable. The admission electrocardiogram (ECG) showed ST segment depression in the anterolateral and inferior leads (Figure 1). The coronary angiogram showed critical ostial stenosis of the right (RCA) and left main coronary artery (Figure 2a, b). Cardiac‐computed tomography showed aortic wall thickening with involvement of bilateral coronary ostia (Figure 2b, c). The patient was referred for coronary bypass surgery after treatment with two doses of penicillin G. The laboratory test was strongly positive for syphilitic infection. Postoperative treatment with benzathine penicillin, in doses recommended for tertiary syphilis, was implemented.

Source: Annals of Noninvasive Electrocardiology - January 1, 2018 Category: Cardiology Authors: Raimundo Barbosa ‐Barros, Andrés R. Pérez‐Riera, Kimmo Koivula, Jairo Carvalho Santos, Luiz C. Abreu, Kjell Nikus Tags: CASE REPORT Source Type: research