# Hypertensive Crisis and Myocardial Infarction With Non-obstructive Coronary Arteries in a Leprosy Patient With Erythema Nodosum Leprosum: The Role of Corticosteroids

## TL;DR

A leprosy patient with a severe skin reaction experienced a heart attack-like event without blocked arteries, highlighting the possible role of corticosteroid treatment.

## Contribution

This case highlights the potential link between ENL, corticosteroid use, and MINOCA in leprosy patients.

## Key findings

- The patient experienced a hypertensive crisis and NSTEMI with non-obstructive coronary arteries.
- ECG and cardiac biomarkers indicated a myocardial infarction despite no significant artery blockage.
- The case suggests a possible association between ENL and cardiovascular complications in leprosy patients.

## Abstract

A hypertensive crisis is a severe condition characterized by a sudden, critical rise in blood pressure, which can lead to organ damage. Myocardial infarction occurring in the absence of significant coronary artery stenosis is referred to as myocardial infarction with non-obstructive coronary arteries (MINOCA). Patients with leprosy may develop erythema nodosum leprosum (ENL), a serious inflammatory condition that can impair cardiovascular health and is frequently treated with corticosteroids. In this case, we describe a 52-year-old male patient, known to have hypertension, who complained of breathlessness, facial edema, and chest pain. Additional testing indicated hypertension, elevated cardiac biomarkers, and an ECG that showed characteristics of a non-ST segment elevation myocardial infarction (NSTEMI). When coronary angiography was performed, non-obstructive epicardial coronary arteries were discovered.