Lesión grave y aislada en el corona coronaria izquierda en un paciente joven

Abstract

Objective: To report the clinical case of a young patient with a subocclusive lesion in the left main coronary artery who underwent angioplasty. Case details: The case of a 25-year-old male patient with clinical syndrome under investigation, with high-risk unstable angina, was reported. The patient had a history of hearing and visual loss since childhood, in addition to hypothyroidism and hypogonadism (hypopituitarism). Throughout his life, he carried out extensive genetic research, without identifying a genetic syndrome that could explain his findings. He was admitted and underwent CT angiography, which showed a severe lesion in the left main coronary artery, without calcification. We opted for percutaneous coronary intervention (PCI) with stent implantation. Approximately 10 months after the coronary event, the patient was admitted with a headache and suspected autoimmune systemic vasculitis. Cogan's Syndrome, a rare inflammatory condition that affects the eyes and ears, and can lead to vasculitis, cardiovascular and central nervous system involvement, was suggested as the only differential diagnosis that would explain all clinical findings (hearing and visual loss, pituitary involvement, already in the sequelae phase and current systemic vasculitis). Final considerations: Cogan's Syndrome can cause severe coronary lesions, requiring early diagnosis and specialized management.