Open heart surgery provides confirmation of coronary and aortic involvement of giant-cell arteritis

The present report describes a 58-year-old woman who had unstable angina pe ctoris 28 months after the end of corticosteroid treatment prescribed for b iopsy-proven temporal arteritis. Coronary angiogram disclosed critical left main coronary artery stenosis. Despite a 3-week corticosteroid regimen no improvement was obtained and an aortocoronary bypass was performed. Histolo gical examination of the affected artery showed vasculitis. Corticosteroid treatment was continued. Six months later, symptoms had not recurred and th e coronary bypass graft was permeable. The stress test was negative fifteen months after surgery and the patient remained clinically well thirty month s later. For any patient with current or previous temporal arteritis, any c ardiovascular manifestation might be a new episode of giant-cell arteritis (J Mal Vasc 1999; 24: 303-305).