A forty-four-year-old woman with Takayasu's arteritis and involvement of the aortic arch and its main branches complained of precordial pain on effort. Exercise electrocardiograms revealed significant ST segment depression in leads II, III, aVF, and V4-6. Coronary arteriograms demonstrated no stenosis. However, the right coronary arteriogram revealed collateral circulation arising from the sinus node artery to the bilateral vertebral arteries and the left internal carotid artery. The collateral circulation was considered to be an important route of blood flow supply to the brain and, at the same time, a cause of coro nary steal syndrome and, consequently, of angina pectoris.
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References
1.
Sumitani T., Genda A., Kanayama H., et al: A case of aortitis syndrome with the collateral circulation from the coronary artery and the right bronchial artery to the lung. Kokyu to Junkan30:1167-1172, 1982 (in Japanese).
2.
Kaneko Y., Goto T., Nishimura K., et al: Surgery for coronary steal syndrome due to fistula between coronary artery and pulmonary artery associated with aortitis syndrome. JpnJ Thorac Surg40:72-75, 1987 (in Japanese).
3.
Kaguraoka H., Itaoka T., Ito H., et al: A case of aortitis syndrome with anastomoses from left coronary artery to bronchial artery. Kokyu to Junkan37:569-572, 1989 (in Japanese).
4.
Sano K., Aiba T., Saito I.: Angiography in pulseless disease. Radiology94:69-74, 1970.
5.
Ishikawa T.: Systemic artery-pulmonary artery communication in Takayasu's aortitis. Am J Roentogenol128:389-393, 1977.
6.
Shimakura T. , Endo M., Konno S.: Coronary angiogram in aortitis syndrome. Shinzo7:1517-1526, 1975 (in Japanese).
