CORONARY ARTERY ECTASIA; PREVALENCE AND CLINICAL CHARACTERISTICS: EXPERIENCE FROM A SINGLE CARDIAC CENTER

Objective: To estimate the incidence and characteristics of coronary artery ectasia in patients undergoing coronary angiography. Study Design: A prospective analysis. Place and Duration of Study: This study was conducted at Army Cardiac Center, Lahore over a period of two years from Jan 2018 to Dec 2019. Methodology: Its prospective analysis of all coronary angiograms performed in our catheterization laboratory during study period. Markis classification was the basis to define and classify coronary artery ectasia. Demographical, clinical, and laboratory data were collected for each patient in this study. Results: A total of 172 (3.9%) out of 4,372 coronary angiograms showed coronary artery ectasia. Among coronary artery ectasia group, mean age 58 ± 10 years, 90% were male, 47% were current smokers, 32% were hypertensive, 15% had diabetes Mellitus and 37% had dyslipidemia. The most common clinical presentation was Non STsegment elevation myocardial infarction (31%), followed by Stable ischemic heart disease in 28%. Right coronary artery was the most frequent coronary artery involved (57%) while Markis Class 3 pattern was seen as most common type of coronary artery ectasia. Conclusion: The frequency of coronary artery ectasia among our patients undergoing coronary angiography was about 4%. Right coronary artery remained the most common affected artery.

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Is Coronary Artery Ectasia a Progressive Disease? A Self-Controlled Retrospective Cohort Study

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.774597 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ruifeng Liu ◽

Huiqiang Zhao ◽

Xiangyu Gao ◽

Siwen Liang

Keyword(s):

Coronary Artery ◽

Clinical Characteristics ◽

Coronary Vessels ◽

Time Interval ◽

Consecutive Series ◽

Gensini Score ◽

Coronary Artery Ectasia ◽

Multilinear Regression ◽

Multilinear Regression Analysis ◽

Over Time

Objective: It is essential to understand whether coronary artery ectasia (CAE) progresses over time because the patients might be under the risk of coronary rupture, and stent implant should be avoided if ectatic changes progress.Methods: A consecutive series of 99 CAE patients who had undergone coronary angiography at least twice were enrolled and followed up for 1–16 years until they received a second angiogram. Subjects were divided into two groups (1–5 vs. 5–16 years of follow-up), then the basic clinical characteristics and coronary artery images were compared over time.Results: (1) All CAE patients exhibited atherosclerosis, and a majority presented with acute myocardial infarction. Most baseline clinical characteristics were relatively stable. (2) Atherosclerosis (indicated by the distribution of stenosis in coronary vessels) and the Gensini scores progressed significantly. Ectasia extent showed minimal changes as indicated by blood vessel involvement, Markis type, coronary blood flow, ectasia diameter, and ectasia length. (3) Multilinear regression analysis revealed that the underlying factors related to stenosis evolution indicated by fold of Gensini score were: longer time interval, lower baseline Gensini score, and higher hypersensitive C-reactive protein concentration. (4) There was a relationship between the ectatic diameter and the extent of stenosis.Conclusions: For CAE patients with atherosclerosis followed for 1–16 years, there was minimal CAE progression, while the atherosclerosis progressed and the ectasia extent was related to degree of stenosis. The results indicate that prevention and treatment of atherosclerotic changes might have more clinical significance than addressing ectatic changes.

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Faculty Opinions recommendation of Clinical characteristics and outcomes of patients with myocardial infarction and cardiogenic shock undergoing coronary artery bypass surgery: data from the society of thoracic surgeons national database.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726048118.793528464 ◽

2017 ◽

Author(s):

Thomas J Papadimos

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Cardiogenic Shock ◽

Coronary Artery Bypass ◽

Coronary Artery Bypass Surgery ◽

Clinical Characteristics ◽

Bypass Surgery ◽

Artery Bypass ◽

National Database

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Role of QRS fragmentation in 12-lead surface ECG in prediction of isolated epicardial coronary artery ectasia and its anatomical distribution in patients without acute coronary syndromes

The Egyptian Heart Journal ◽

10.1186/s43044-020-00054-4 ◽

2020 ◽

Vol 72 (1) ◽

Author(s):

Diaa Kamal ◽

Moataz Hashem

Keyword(s):

Coronary Artery ◽

Acute Coronary Syndromes ◽

Coronary Artery Ectasia ◽

Anatomical Distribution ◽

Epicardial Coronary Artery ◽

Surface Ecg ◽

Qrs Fragmentation ◽

Coronary Syndromes

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A pebble clogging a river: a case report of thrombosed coronary aneurysmal ectasia

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa274 ◽

2020 ◽

Author(s):

Akshar Jaglan ◽

Tarek Ajam ◽

Steven C Port ◽

Tanvir Bajwa ◽

A Jamil Tajik

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Kawasaki Disease ◽

Treatment Options ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Coronary Artery Ectasia ◽

Ventricular Ejection Fraction ◽

Coronary Syndrome ◽

Patient Reported

Abstract Background Coronary artery ectasia (CAE) is a rare anomaly that can present at any age. Predisposing risk factors include Kawasaki disease in a younger population and atherosclerosis in the older generation. We present a unique case of the management of a young woman diagnosed with multivessel CAE with aneurysmal changes in the setting of acute coronary syndrome and subsequently during pregnancy. Case summary A 23-year-old woman presented with acute onset chest pain. Electrocardiogram revealed no ischaemic changes; however, troponin I peaked at 16 ng/mL (reference range 0–0.04 ng/mL). Echocardiogram showed apical dyskinesis with preserved left ventricular ejection fraction. Coronary angiography showed multivessel CAE along with significant thrombus burden in an ectatic lesion of the left anterior descending artery. Since the patient was haemodynamically stable, conservative management with dual antiplatelet therapy and anticoagulation was started. On follow-up, coronary computed tomographic angiogram illustrated resolution of the coronary thrombi and echocardiogram showed improvement to the apical dyskinesis. It was presumed that Kawasaki disease was the most likely aetiology of her disease. Subsequently the patient reported that, contrary to medical advice, she was pregnant, adding another layer of complexity to her case. Discussion Coronary artery ectasia can be discovered as an incidental finding or can present with an acute coronary syndrome. Management is challenging in the absence of randomized trials and large-scale data. Treatment options include medications, percutaneous intervention, and surgical revascularization. Close surveillance is required in these patients to assess progression of disease. Here we discuss treatment options during acute coronary syndrome and pregnancy.

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