Takayasu Arteritis as an Odd Cause of Chest Pain

We describe a case of Takayasu arteritis with unusual presentation, having chest pain as the main symptom and a nasal septal perforation as a rare complication, without upper and lower extremities, abdominal, neck or cerebral compromise. The patient, a 34 year-old male, previously healthy, presented with acute onset of chest pain, dyspnea and severe compromise of his functional status. Severe stenosis of pulmonary arteries and coronaries, as well as signs of aortitis were found in a CT angiography of the thorax, pulmonary angiography and right and left heart catheterization . Anti-neutrophil cytoplasmic antibodies were positive. The patient received 750 mg of Methylprednisolone and monthly bolus of Cyclophosphamide. Six months after the diagnosis, the patient developed a nasal septal perforation. This is the first reported case of Takayasu arteritis with rapidly progressing coronary disease as the only presentation, complicated by a nasal septal perforation.