Extensive triple vessel coronary artery disease in a young male with juvenile idiopathic arthritis

The risk of cardiovascular disease in patients with chronic inflammatory joint conditions is substantially increased compared to the general population. We present a case of a 27-year-old male with a chronic history of juvenile idiopathic arthritis (JIA) who presented with denovo acutely decompensated chronic heart failure. He had no traditional risk factors for atherosclerotic cardiovascular disease (ASCVD). However, during his workup for dilated cardiomyopathy, he was found to have extensive triple vessel disease on coronary artery angiography, and this was subsequently thought to be the most likely aetiology for the dilated cardiomyopathy despite being of young age. The chronic JIA was identified as the principal risk factor for the ischaemic cardiomyopathy. Clinicians treating patients with rheumatological conditions should routinely screen for ASCVD, despite the absence of traditional cardiovascular risk factors.