EC Cardiology

Atherosclerosis related disease is one of the leading causes of death in the United States. It affects multiple arterial systems in the body common being coronary artery disease, peripheral vascular disease, carotid artery disease, renal artery stenosis, vertebral artery disease and mesenteric artery disease etc. depending on the affected part of the body. Of these, complex aortic atheromatous plaques carry significant risk for causing embolisation either occurring spontaneously or iatrogenic with catheterization procedures contributing to about 14% in patients with peripheral embolisation, atrial fibrillation and stroke. Complex aortic plaques contribute to a significant mortality risk as high as 20% in three years and it affects the outcomes of interventional cardiac surgeries by increasing mortality and morbidity. Multiple factors increase the risk of embolisation including plaque location, thickness, ulceration and mobility. Various studies assessed multiple significant risk factors for atherosclerosis including hypertension, hyperlipidemia with high LDL lipoproteins, lack of physical exercise, high fat diet, low antioxidant levels, smoking, metabolic syndrome, family history, male sex, depression, elevated levels of homocysteine and systemic inflammatory markers. In addition to these risk factors, chronic inflammatory conditions like Rheumatoid arthritis, SLE also increase the risk of atherosclerosis. Oftentimes, it becomes clinically significant when a patient starts to experience symptoms due to unstable atheromatous plaques. We report a case with multiple unstable atheromatous plaques with multiple organ involvement simultaneously and discuss the clinical significance and management.

Keywords: Atherosclerosis; Atheromatous Plaques; SLE

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