Clinical significance of coronary arterial ectasia

Coronary artery ectasia presenting with acute inferior wall myocardial infarction in a young adult

“…One or more of the coronary arteries can be affected. CAE can be acquired or congenital, and it has an estimated prevalence of 1.2–4.9% in several coronary angiographic studies [2–4]. More than 50% of cases are reportedly related to atherosclerosis.…”

“…The literature suggests that enzymatic degradation of the media plays a major role in pathogenesis of CAE through ‘exaggerated expansive remodeling’, which in turn is mediated by several factors in atherosclerotic process, such as lipoprotein accumulation in the intima, oxidative stress, inflammatory cell infiltration, altered nitric oxide metabolism, and reduced shear stress. Histologically, ectatic coronary arterial segments reveal the breakdown of the medial collagen and elastin components with disruption of the internal and external elastic lamina [4,5]. …”

“…The predilection of CAE for RCA is not clear. Markis et al proposed classification of CAE based on the extent of anatomic involvement as below [4]:type I – diffuse ectasia of two or three vesselstype II – diffuse ectasia in ine vessel and localized in anothertype III – diffuse ectasia of one vessel onlytype IV – localized or segmental ectasia. …”

Aneurysm of the main stem of the left coronary artery associated with aortic insufficiency and aneurysm of the ascending aorta. Report of a case with successful surgical repair.

“…With the development of coronary angiography, however, they have been recognised more often and during life. Recently, Falsetti et al (1976) reviewed reports of 34 cases, and Markis et al (1976) reported on a further 30 patients.…”

“…It has usually been performed because of a history of myocardial infarction (Ebert et al, 1971;Konecke et al, 1971;Ghahramani et al, 1972;Crook et al, 1973;Toussaint et al, 1976), on account of angina pectoris (Markis et al, 1976), unexplained dysrhythmias, or because of calcification observed on plain chest radiographs or during aortography (present report).…”