Coronary artery ectasia and triple-vessel disease

Česká verzia

Authors: P. Jarkovský
Authors place of work: Interní klinika 1. lékařské fakulty UK a ÚVN Praha, přednosta pplk. prof. MUDr. Miroslav Zavoral, Ph. D.
Published in the journal: Vnitř Lék 2009; 55(1): 66-69
Category: Case Reports

Summary

Coronary artery ectasia (CAE) is an entity common known from 18th century. The advance in imaging methods, especially in coronary angiography, leads to more precise data about incidence of CAE among population, which is stated from 0.2 to 4.9%. Etiology of CAE is various. CAE can be rarely congenital in origin, can be associated with connective tissue disorders, and also CAE can be a iatrogenic lesion following percutaneous intervention. CAE is often accompanied by coronary artery disease (CAD). We report a case of woman with NSTEMI as a first manifestation of ischemic heart disease, with triple-vessel disease and CAE of LAD and RC, who was managed conservatively with a good effect. We discuss various possibilities of treatment of CAE.

Key words:
coronary artery ectasia – acute coronary syndrome – aneurysm

Zdroje

1. Markis JE, Joffe CD, Cohn PF et al. Coronary artery ectasia. Its prevalence and clinical signifikance of coronary artery ectasia. Am J Cardiol 1976; 37: 217–222.

2. Virmani R, Robinnowitz M, Atkinson JB et al. Acquired coronary arterial aneurysma: an autopsy study of 52 patients. Hum Patol 1986; 17: 575–583.

3. Daoud AS, Pankin D, Tulgan H et al. Aneurysms of the coronary artery – report of ten cases and review of the literature. Am J Cardiol 1963; 11: 228–237.

4. Stajduhar KC, Laired JR, Rogan KM et al. Coronary arterial ectasia: Increased prevalence in patients with abdominal aortic aneurysm as compared to occlusive atherosclerotic periferal vascular disease. Am Heart J 1993; 125: 86–92.

5. Swaye PS, Fisher LD, Litwin P et al. Aneurysmal coronary artery disease. Circulation 1983; 67: 134–138.

6. Bulava A, Škvařilová M, Lukl J. Aneurysma koronárních arterií: přehled dostupné literatury. Cor et Vasa 2001; 4: 197–204.

7. Sharma SN, Kaul U, Sharma S et al. Coronary arteriographic profile in young and old Indian patiens with ischemic heart disease: a comparative study. Indian Heart J 1990; 42: 365–369.

8. Manginas A, Cokkinos DV. Coronary artery ectasia: imaging, functional assessment and clinical implications. Eur Heart J 2006; 27: 1026–1031.

9. Davidson A, Eshaghpour E, Young N et al. Late thrombosis of a coronary artery mycotic aneurysm. Am Heart J 1991; 121: 1549–1550.

10. England JF. Herbicides and coronary artery ectasia (letter). Med J Aust 1981; 65: 260.

11. Satran A, Bart BA, Henry CR et al. Increased prevalence of coronary artery aneurysms among cocain users. Circulation 2005; 111: 2424–2429.

12. Saglam M, Karakaya O, Barutcu I et al. Identifying cardivascular risk factor in a patient population with coronary artery ectasia. Angiology 2008; 58: 698–703.

13. Kruger D, Stierle U, Herrmann G et al. Exercise induced myocardial ischemia in isolated coronary ectasia and aneurysma (“dilatated coronaropathy”). J Am Coll Cardiol 1999; 34: 1461–1470.

14. Sayin T, Doven O, Berkalp B et al. Exercise‑induced myocardial ischemia in patients with coronary artery ectasia without obstructive coronary artery disease. Int J Cardiol 2001; 78: 143–149.

15. Papadakis MC, Manginas A, Cotileas P et al. Documentation of slow coronary flow by the TIMI frame count in patients with coronary ectasia. Am J Cardiol 2001; 88: 1030–1032.

16. Akyurek O, Berkalp B, Sayin T et al. Altered coronary flow properties in diffuse coronary artery ectasia. Am Heart J 2003; 145: 66–72.

17. Suzuki H, Takeyama Y, Hamazaki Y et al. Coronary spasm in patients with coronary ectasia. Cathet Cardiovasc Diagn 1994; 32: 1–7.