Isolated Bilateral Coronary Ostial Stenosis in Behçet's Disease.

We herein report the case of a 67-year-old woman with isolated bilateral coronary ostial stenosis in Behçet's disease (BD). She was diagnosed BD 10 years previously, and steroids had been administered as treatment. Her coronary risk factors were hypertension and dyslipidemia, and she presented with recent onset angina. Computed tomography coronary angiography showed severe calcification of the bilateral coronary ostia (Picture 1). Other imaging modalities showed no aorto-ostial lesions. Coronary angiography showed intermediate ostial stenosis of the right coronary artery and severe stenosis of the left main coronary artery (Picture 2). Based on the fractional flow reserve values (right coronary artery: 0.85, left anterior descending artery: 0.68, and left circumflex artery: 0.75), she underwent coronary bypass surgery. Although BD is a systemic inflammatory disease that can affect all types and sizes of blood vessels, coronary involvement is rare (1,2).

Picture 1.

Picture 2.