Coronary artery aneurysm

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S. [3]

Overview

Coronary artery aneurysm is an abnormal dilatation of a coronary artery segment over 1.5 times the diameter of normal adjacent segment.[1]

Epidemiology and Demographics

The incidence of CAA ranges widely between 0.3-5.3% within angiographic series with a mean incidence of 1.65%.[2] A highest incidence of 10-12% was reported in a study from India. Perhaps reflecting a specific genetic and/or environmental predisposition.[3]

CAA most commonly occurs in right coronary artery accounting for 40-87% followed by left anterior descending artery and left circumflex artery.[4][5]. CAA of left main artery or triple-vessel CAA are rare[4]

Diagnosis

It is often found coincidentally on coronary angiography.[6]

Causes

Causes include atherosclerosis,[7] Kawasaki disease[8] and coronary catheterization as well as vasculitides and collagen vascular diseases.

Prognosis

It has a good prognosis.[6]

Definition

A localized arterial widening (dilatation) that usually manifests itself as a bulge. Its presence may lead to weakening of the wall and eventual rupture.

Grade 0

None – no ectasia present.

Grade 1

Ectasia – visual assessment of ectasia >1 & < 1.5 times the normal artery diameter located anywhere in the culprit artery.

Grade 2

Aneurysm – visual assessment of an aneurysm > 1.5 times the normal artery diameter located anywhere in the culprit artery.

Angiography Examples

Click here for angiography examples of coronary artery aneurysm.

References

  1. Jarcho S (1969). "Bougon on coronary aneurysm (1812)". Am J Cardiol. 24 (4): 551–3. PMID 4897732.
  2. Hartnell GG, Parnell BM, Pridie RB (1985). "Coronary artery ectasia. Its prevalence and clinical significance in 4993 patients". Br Heart J. 54 (4): 392–5. PMC 481917. PMID 4052280.
  3. Sharma SN, Kaul U, Sharma S, Wasir HS, Manchanda SC, Bahl VK; et al. (1990). "Coronary arteriographic profile in young and old Indian patients with ischaemic heart disease: a comparative study". Indian Heart J. 42 (5): 365–9. PMID 2086442.
  4. 4.0 4.1 Villines TC, Avedissian LS, Elgin EE (2005). "Diffuse nonatherosclerotic coronary aneurysms: an unusual cause of sudden death in a young male and a literature review". Cardiol Rev. 13 (6): 309–11. PMID 16230889.
  5. Swaye PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG; et al. (1983). "Aneurysmal coronary artery disease". Circulation. 67 (1): 134–8. PMID 6847792.
  6. 6.0 6.1 Pahlavan PS, Niroomand F (2006). "Coronary artery aneurysm: a review". Clin Cardiol. 29 (10): 439–43. PMID 17063947. Unknown parameter |month= ignored (help)
  7. Nichols L, Lagana S, Parwani A (2008). "Coronary artery aneurysm: a review and hypothesis regarding etiology". Arch. Pathol. Lab. Med. 132 (5): 823–8. PMID 18466032. Unknown parameter |month= ignored (help)
  8. Fukazawa R, Ikegam E, Watanabe M; et al. (2007). "Coronary artery aneurysm induced by Kawasaki disease in children show features typical senescence". Circ. J. 71 (5): 709–15. PMID 17456996. Unknown parameter |month= ignored (help)


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