Key result
A 42-year-old male presenting with shortness of breath was diagnosed with three-vessel coronary artery ectasia and severe left ventricular dysfunction, which was managed with percutaneous coronary intervention.
Why the study?
Coronary artery ectasia is a rare finding encountered during coronary angiography, and further trials are required to optimize related management guidelines.
Case Report (n=1)
No
This case highlights the clinical presentation and complex percutaneous management of severe coronary artery ectasia complicated by obstructive CAD and cardiogenic shock.
PCI feasible in rare multivessel ectasia with LV dysfunction; hypothesis-generating, should not change practice.
The localized or diffused dilation of a coronary artery lumen is referred to as coronary artery ectasia (CAE). Though it is well recognized, CAE is a rare finding that is encountered in the diagnostic procedure of coronary angiography. This form of atherosclerotic coronary artery disease (CAD) can be found in 1.4-4.9% of all coronary angiography patients. CAE can manifest in combination with stenotic lesions or present as an isolated condition. Its risk factors are similar to those of atherosclerosis. The underlying pathophysiology involves a vascular remodeling response to atherosclerosis. Enzymatic degradation by matrix metalloproteinases (MMP) and accumulation of lipoproteins play an important role in the remodeling process. CAE can be diagnosed with the help of imaging modalities such as coronary CT angiogram (CTA) and coronary magnetic resonance angiogram (MRA); coronary angiography is considered the gold standard procedure. The management strategies include treating the cardiovascular risk factors, prevention of thromboembolic events, and percutaneous/vascular revascularization. CAE can be managed medically, but percutaneous/surgical revascularization [coronary artery bypass grafting (CABG)] is an option to treat patients with co-existing symptomatic obstructive lesion refractory to medical treatment. Further trials are required to optimize the management guidelines related to CAE. In this report, we describe the case of a 42-year-old man with a past medical history of hypertension, hyperlipidemia, and asthma who presented with shortness of breath and minimally elevated troponin level. Coronary angiography revealed three vessels with ectasia and severe left ventricular dysfunction on ventriculography.
No takes yet. Share an insight, caveat, or question.
Al-Zakhari et al. (2021) conducted a case report in Coronary Artery Ectasia (n=1). Percutaneous coronary intervention was evaluated. A 42-year-old male presenting with shortness of breath was diagnosed with three-vessel coronary artery ectasia and severe left ventricular dysfunction, which was managed with percutaneous coronary intervention.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: