Coronary artery ectasia current concepts and interventions

Sontineni, Siva P.

doi:10.2741/e377

Cited by 30 publications

(7 citation statements)

References 76 publications

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“…Overall, ~ 20–30% CAE cases are congenital, with the remainder being acquired, and up to 20% acquired CAE is attributed to atherosclerosis, which is mostly associated with obstructive coronary artery disease [6]. Congenital CAE is mainly linked to cardiac anomalies, such as bicuspid aortic valve, aortic root dilation, ventricular septal defect or pulmonary stenosis [6, 7]. Acquired CAE association with inflammatory or connective tissue disorder constitutes only 10–20% cases, such as scleroderma Elhers-Danlos syndrome, anti-neutrophil cytoplasmic antibody-related vasculitis syphilitic aortitis and Kawasaki disease [8].…”

Section: Discussionmentioning

confidence: 99%

Is KCNH1 mutation related to coronary artery ectasia

Noori

Zhang

Pan

2019

BMC Cardiovasc Disord

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BackgroundCoronary artery ectasia (CAE) is an uncommon finding in patients undergoing coronary angiography and acute myocardial infarction is an extremely uncommon condition in the presence of coronary artery ectasia. To date, 50 gene variants associated with coronary artery disease have been identified, but none appear to be related to coronary artery ectasia.Case presentationThis is a rare case of Coronary artery ectasia which is considered to be related to Gene variations in potassium voltage-gated channel subfamily H member 1, KCNH1 (encoding a protein designated ether à go-go, EAG1 or KV10.1).ConclusionOccurrence of Acute myocardial infarction in patient with coronary artery ectasia after diarrhea is a very rare condition and involvement of KCNH1 gene mutation which is described in this case report.

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Section: Discussionmentioning

confidence: 99%

Is KCNH1 mutation related to coronary artery ectasia

Noori

Zhang

Pan

2019

BMC Cardiovasc Disord

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“…Prior to diagnosis, patients often have a history of frequent visits to healthcare services; if left undiagnosed, CHS can lead an overuse of medical resources and a decrease in quality of life. Based on previously published case reports, some authors have listed a series of clinical characteristics to assist in the diagnosis of CHS [4].…”

Section: Discussionmentioning

confidence: 99%

Cannabinoid Hyperemesis Syndrome

et al. 2013

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Recent articles published in CNS Neuroscience and Therapeutics reflect the increasing interest of the scientific community in the therapeutic properties of cannabis [1,2]. However, an aspect that is commonly overlooked is the potential medical side effects of cannabis use, among which severe hyperemesis is an uncommon condition.Cannabinoid hyperemesis syndrome (CHS) occurs in chronic, daily cannabis users and is characterized by cyclic vomiting and compulsive bathing behavior. This clinical manifestation is paradoxical, given the previously identified therapeutic role of cannabis as an antiemetic agent. We report a recent case of CHS associated with organic and psychiatric complications that was diagnosed at our center.A 36-year-old Hispanic woman attended the emergency department of a tertiary hospital presenting with second-degree burns on 20% of her body surface. These had been caused by repeated showers in excessively hot water. She also reported a history of frequent episodes of nausea and vomiting for the previous 24 months, which after several inconclusive assessments had been attributed to anxiety. She denied any medical or surgical history, except diagnosis of gastritis in 2011, treated with omeprazole. She had visited the emergency department on several occasions during the previous 5 years referring anxiety and abdominal pain associated with vomiting and compulsive hot showers which the patient had claimed were aimed at relieving anxiety symptoms, and which were considered to be part of an obsessive-compulsive disorder (OCD). She had been treated with antidepressant and anxiolytic drugs without clear improvement. She admitted to smoking marijuana daily for at least 5 years, while she denied the use of any other illicit substances. The patient was admitted for evaluation and was administered acid-suppressive medications, antiemetics, rehydration, and topical treatment.The patient's laboratory data at admission were normal, except for hypokalemia and a positive urinary drug screen for cannabis, while the physical examination yielded no additional information. During the length of the patient's hospital admission, she continued to take hot showers numerous times each day.Taking into account the patient's clinical presentation and her history of regular cannabis use, she was diagnosed with CHS. The patient was informed of the diagnosis, and of the need to cease her marijuana use. On further questioning, the patient confirmed persistent, daily marijuana use over the past 5 years. Following liaison with her psychiatrist, she was referred to a drug treatment center to address her cannabis use disorder, while her OCD diagnosis was withdrawn and her medication modified. Six months later, she had succeeded in giving up cannabis use entirely, she had not suffered any further episodes of nausea or vomiting, and she showered once daily with mild warm water.

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“…4 Coronary artery ectasia is defined when the dilated segment involves more than one-third of vessel length. 5 After the first historical description of CAA by Morgagni, 6 several cases have been published, 7 and the International Coronary Artery Aneurysm Registry (CAAR) found a prevalence of 0.35% among 436,467 patients referred to invasive coronary angiography (ICA). 8 Although heterogeneous systemic or cardiovascular conditions may underlie CAA development, the disarray of the components of vascular tunica media may be a common mechanism.…”

Section: Introductionmentioning

confidence: 99%

Etiology, clinical presentation, and management of left main coronary artery aneurysms

Negro

Gentile

Rizza

et al. 2022

Journal of Cardiac Surgery

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Background and Aim of the Study The widespread use of noninvasive/invasive coronary imaging increased the probability of recognition of coronary aneurysms. Left main coronary aneurysms (LMCA), though rare, are potentially life‐threatening but in the absence of controlled studies, guidelines do not provide any specific recommendation for their management. We, therefore, aimed to investigate the epidemiology, clinical presentation, therapeutic strategies, and prognostic implication of LMCA. Methods A systematic review of the literature was performed to retrieve all the reported cases of LMCA as of December 2021, which were summarized and classified according to their etiology, clinical presentation, and therapeutic management. Results Out of 1997 works retrieved, 180 studies were analyzed, describing 209 LMCA cases (aged 51 ± 19 years, 68% males). Atherosclerosis was the most common etiology (40%), followed by inflammatory (12%), congenital (9%), or degenerative (6%) conditions. Stable angina (43%) and acute coronary syndromes (32%) were more often the first clinical manifestations, while 29 (14%) LMCA were incidental findings. Most cases were treated surgically (53%), while percutaneous intervention was rarely adopted (7%). Data about antithrombotic therapies were scarce and heterogeneous. Finally, when longitudinal data were reported (n = 81), LMCA resulted associated with a severe prognosis, with a 15% mortality over an 8‐month median follow‐up. Conclusions LMCA are most frequently, but not exclusively, caused by advanced atherosclerosis. Irrespective of their etiology and clinical presentation, LMCA may be associated with high short‐term mortality. In absence of controlled studies, a careful evaluation of each case is warranted to optimize therapeutic strategies.

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Coronary artery ectasia current concepts and interventions

Cited by 30 publications

References 76 publications

Is KCNH1 mutation related to coronary artery ectasia

Is KCNH1 mutation related to coronary artery ectasia

Cannabinoid Hyperemesis Syndrome

Etiology, clinical presentation, and management of left main coronary artery aneurysms

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