Coronary artery aneurysm: Difference between revisions
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==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
The incidence of CAA ranges widely between 0.3-5.3% within angiographic series with a mean incidence of 1.65%.<ref name="pmid4052280">{{cite journal| author=Hartnell GG, Parnell BM, Pridie RB| title=Coronary artery ectasia. Its prevalence and clinical significance in 4993 patients. | journal=Br Heart J | year= 1985 | volume= 54 | issue= 4 | pages= 392-5 | pmid=4052280 | doi= | pmc=PMC481917 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4052280 }} </ref> | The incidence of CAA ranges widely between 0.3-5.3% within angiographic series with a mean incidence of 1.65%.<ref name="pmid4052280">{{cite journal| author=Hartnell GG, Parnell BM, Pridie RB| title=Coronary artery ectasia. Its prevalence and clinical significance in 4993 patients. | journal=Br Heart J | year= 1985 | volume= 54 | issue= 4 | pages= 392-5 | pmid=4052280 | doi= | pmc=PMC481917 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4052280 }} </ref> A highest incidence of 10-12% was reported in a study from India. Perhaps reflecting a specific genetic and/or environmental predisposition.<ref name="pmid2086442">{{cite journal| author=Sharma SN, Kaul U, Sharma S, Wasir HS, Manchanda SC, Bahl VK et al.| title=Coronary arteriographic profile in young and old Indian patients with ischaemic heart disease: a comparative study. | journal=Indian Heart J | year= 1990 | volume= 42 | issue= 5 | pages= 365-9 | pmid=2086442 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2086442 }} </ref> | ||
CAA most commonly occurs in [[right coronary artery]] accounting for 40-87% followed by [[left anterior descending artery]] and [[left circumflex artery]].<ref name="pmid16230889">{{cite journal| author=Villines TC, Avedissian LS, Elgin EE| title=Diffuse nonatherosclerotic coronary aneurysms: an unusual cause of sudden death in a young male and a literature review. | journal=Cardiol Rev | year= 2005 | volume= 13 | issue= 6 | pages= 309-11 | pmid=16230889 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16230889 }} </ref><ref name="pmid6847792">{{cite journal| author=Swaye PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG et al.| title=Aneurysmal coronary artery disease. | journal=Circulation | year= 1983 | volume= 67 | issue= 1 | pages= 134-8 | pmid=6847792 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6847792 }} </ref> | |||
CAA most commonly occurs in [[right coronary artery]] accounting for 40-87% followed by [[left anterior descending artery]] and [[left circumflex artery]].<ref name="pmid16230889">{{cite journal| author=Villines TC, Avedissian LS, Elgin EE| title=Diffuse nonatherosclerotic coronary aneurysms: an unusual cause of sudden death in a young male and a literature review. | journal=Cardiol Rev | year= 2005 | volume= 13 | issue= 6 | pages= 309-11 | pmid=16230889 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16230889 }} </ref><ref name="pmid6847792">{{cite journal| author=Swaye PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG et al.| title=Aneurysmal coronary artery disease. | journal=Circulation | year= 1983 | volume= 67 | issue= 1 | pages= 134-8 | pmid=6847792 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6847792 }} </ref>. CAA of left main artery or triple-vessel CAA are rare<ref name="pmid16230889">{{cite journal| author=Villines TC, Avedissian LS, Elgin EE| title=Diffuse nonatherosclerotic coronary aneurysms: an unusual cause of sudden death in a young male and a literature review. | journal=Cardiol Rev | year= 2005 | volume= 13 | issue= 6 | pages= 309-11 | pmid=16230889 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16230889 }} </ref> | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 02:35, 29 September 2012
| Coronary artery aneurysm | |
| ICD-10 | I25.4 |
|---|---|
| ICD-9 | 414.11 |
| MeSH | D003323 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S. [3]
Overview
Coronary artery aneurysm (CAA) 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.
- NOTE: An aneurysm can be further classified as either saccular (wider than it is long) or fusiform (elongated).
References
- ↑ Jarcho S (1969). "Bougon on coronary aneurysm (1812)". Am J Cardiol. 24 (4): 551–3. PMID 4897732.
- ↑ 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.
- ↑ 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.
- ↑ 4.0 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.
- ↑ 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.
- ↑ 6.0 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) - ↑ 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) - ↑ 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)