Coronary Aneurysms and Ectasia as an Unexpected Cause of Myocardial Ischemia

Sofía MC1,2, Raúl VC1,2, Miguel Ángel SR2, De La Puente-Tawil I2, José Ángel AL2, Irune ML2, Fernández-De La Torre M2 and Erick AR1,3*

1Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico
2Universidad La Salle, Mexico City, Mexico
3Universidad Nacional Autónoma de México, Mexico

^*Correspondance to: Erick Alexanderson-Rosas 

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Abstract:

Coronary Artery Aneurysms (CAA) and Coronary Artery Ectasia (CAE) are rare but serious conditions associated with distinct entities and many possible complications. These conditions are often diagnosed incidentally during angiography, nevertheless they usually present with stable angina, atypical precordial pain, or acute coronary syndrome. A 56-year-old male patient is presented in this article after arriving at a local hospital with intense, retrosternal oppressive chest pain associated with nausea and diaphoresis and a history of chronic ischemic heart disease. After a 12-lead Electrocardiogram (EKG) was performed, he was diagnosed with an inferolateral acute ST-Elevated Myocardial Infarction (STEMI) and was admitted to a cardiac catheterization laboratory for coronary angiography, the procedure showed evidence of both CAA and CAE. The main cause of CAA in the adult population is arteriosclerosis and presents as local dilation of the coronary artery, whereas CAE presents as diffuse involvement. Unlike aneurysms, ectasia is more frequently seen in association with atherosclerosis, still, both conditions increase the risk of Acute Myocardial Infarction (AMI) and should be considered in any patient with high clinical suspicion and a history of angina or acute myocardial infarction. Angiography is considered the first-choice diagnostic study.

Keywords:

Coronary ectasia; Coronary aneurysm; Myocardial ischemia; Hemodynamics

Cite the Article:

Sofía MC, Raúl VC, Miguel Ángel SR, De La Puente-Tawil I, José Ángel AL, Irune ML. Coronary Aneurysms and Ectasia as an Unexpected Cause of Myocardial Ischemia. Ann Clin Case Rep. 2023; 8: 2427.