Inflammatory arteritis with reversible coronary localization in a 70-year-old woman.

Giant cell arteritis with coronary involvement is an uncommon event, often discovered at autopsy after a myocardial infarction. We report the case of a 70-year-old female with unstable angina pectoris persisting despite angioplasty and antianginal treatment, associated with chronically increased erythrocyte sedimentation rate. Temporal artery biopsy was negative but ophthalmic assessment showed sequelae of ischaemic optical neuritis. Response to prednisone therapy was striking, with complete disappearance of angina pectoris, normalization of erythrocyte sedimentation rate and decreased thallium uptake at scintigraphy. This is the first case of giant cell arteritis of the coronary arteries seen after attempted therapy with percutaneous transluminal coronary angioplasty. Such findings justify considering giant cell arteritis each time a case of coronary manifestations with increased erythrocyte sedimentation rate resists medical treatment, or recurs after coronary angioplasty.