Background Takayasu arteritis (TA), a systemic vasculitis typically occurring in female patients aged ≤40, can affect the coronary arteries and cause ischemic heart disease. The prevalence of TA among young females with acute ischemic heart disease is undetermined.

Objectives In this study, we investigated the prevalence of TA in young women presenting with ischemic heart disease in the Emergency Department.

Methods We conducted a retrospective evaluation of the hospital records of 172,790 consecutive female patients aged <45, who accessed the Emergency Department of our institution over 8 consecutive years (2007–2015). The prevalence of TA and of other etiologies of ischemic heart disease was determined. Diagnosis of TA was established based on the 1990 American College of Rheumatology criteria.

Results Overall, 2,090 women aged <45 presented to the Emergency Department with chest pain, dyspnea, palpitations, angina, heart failure, or cardiac arrest; 40 had confirmed acute ischemic heart disease. The etiology was “classic” atherosclerosis in 24 cases (60%), TA in 4 cases (10%), vasospasm and sympathomimetic drug abuse in 3 cases each (7.5%), coronary artery dissection and microvascular angina in 2 cases each (5%), Takotsubo and radiation-induced cardiomyopathy in 1 case each (2.5%).

Conclusions Although a diagnosis of TA is likely to be overlooked, TA is not infrequent in younger females presenting with acute ischemic heart disease. Specifically, TA accounted for 10% of cases of acute ischemic heart disease in female patients aged <45, a finding relevant to the diagnosis and management of these young patients.

Disclosure of Interest None declared