# Rare Manifestation of COVID-19 Resulting in Coronary Artery Vasculitis

## TL;DR

A patient with end-stage kidney disease developed severe heart artery issues linked to COVID-19 vasculitis and was successfully treated with surgery.

## Contribution

Highlights a rare case of coronary artery vasculitis as a complication of COVID-19 in a patient with ESRD.

## Key findings

- Patient showed new severe coronary artery lesions and aneurysm after initial normal angiogram.
- Diagnosis of vasculitis was made after ruling out autoimmune causes and confirming SARS-CoV-2 infection.
- Successful treatment via coronary artery bypass grafting led to full recovery.

## Abstract

We present the case of a 59-year-old African American female with end-stage renal disease (ESRD) who presented to the emergency department with chest discomfort. She had a coronary angiogram six months ago that showed no occlusive epicardial coronary artery disease. She had elevated troponin I levels and new regional wall motion abnormalities on echocardiogram. Her SARS-CoV-2 returned positive. After a multidisciplinary team approach, she underwent another coronary angiogram that showed new severe multivessel ostial lesions and a left main coronary artery aneurysm. COVID-19-related coronary artery vasculitis was suspected based on her clinical presentation, angiogram findings, and negative autoimmune workup. The patient underwent successful coronary artery bypass grafting and recovered without complications.