Coronary Artery Ectasia

Abstract

Some individuals develop a rare form of coronary heart disease called coronary artery ectasia (CAE). It is characterized by a dilation of more than one-third of the length of a coronary artery and a diameter that is 1.5 times that of the adjacent normal coronary artery. In the absence of significant coronary constriction, angina pectoris, positive stress tests, and acute coronary syndromes may all be indications of CAE. A distal embolization, vasospasm, or vascular rupture may cause thrombus formation in an ectatic artery. Antiplatelets, such as aspirin, are the cornerstone of treatment for people with CAE. Anticoagulants are used to prevent thrombus formation based on the presence of concurrent obstructive coronary artery disease and the patient’s risk of bleeding. As atherosclerosis is the most common cause of CAE, all patients are advised to take statins for primary prevention. Due to their anti-inflammatory properties, angiotensin-converting enzyme inhibitors may be prescribed to individuals with hypertension. If hypertension and coronary vasospasm occur simultaneously, beta-blockers and calcium channel blockers may be beneficial. Because they may aggravate symptoms, nitrates are normally not suggested. Other CAE treatment methods include the prevention of thromboembolic complications and percutaneous or surgical revascularization. CAE prognosis is determined on the severity of the associated coronary artery.

Angiographic characteristics of coronary artery disease in patients undergoing diagnostic coronary angiography at a tertiary hospital in Tanzania

“…Noteworthy, about 5.36% of patients were found to have coronary vessel abnormalities which include ecstatic, tortious and sluggishly flowing vessels, in agreement with previous reports [ 27 ]. These aberrant vessels could be associated with inadequate blood supply to meet the myocardial demand resulting in ischemic pain.…”

“…The mechanisms for the vascular aberrations are not well understood. However, developmental anomalies during embryological morphogenesis due to hitherto unknown causes could be the underlying insults [ 27 ]. Recently, overexpression of vascular endothelial growth factor – beta (VEGF-β) in mice has been shown to promote the proliferation of endothelial cells and coronary vessels in the embryological heart development [ 28 ].…”

Coronary Artery Ectasia: Case Reports and Literature Review

“…This can be explained by residual thrombus, turbulent flow, and the high risk of stent malposition [12][13]. In acute myocardial infarction, coronary blood flow can also be restored by medical therapy with heparin infusion as well as thrombolysis [2][3][4][5][6][7][8][9][10][11][12][13][14][15].…”

“…Coronary angiography stands as the foremost method for diagnosing coronary aneurysms, offering insights not just into their shape, size, location, and severity, but also into the potential existence of coronary stenosis [ 8 ]. CAE can also be diagnosed with noninvasive modalities such as coronary magnetic resonance angiography (MRA) and coronary artery computed tomography (CACT) [ 9 ].…”

Angiographic Features of Patients With Coronary Artery Ectasia Compared With Stenotic Coronary Artery Disease

“…Some patients present with myocardial ischemic symptoms, whereas others present with symptoms of systemic disease. (11)Thus, the study's main objective is to compare the angiographic features of patients with coronary artery ectasia with those of patients with stenotic coronary artery disease.…”