Coronary artery aneurysm
Coronary artery aneurysm | |
---|---|
coronary angiography | |
Treatment | medical management, surgical excision, coronary bypass grafting (CABG), and percutaneous coronary interventions[1] |
Coronary artery
Signs and symptoms
The majority of individuals suffering from coronary artery aneurysms do not exhibit any symptoms; the development of complications or concurrent atherosclerotic
Causes
Acquired causes include
It can also be congenital.[6][7] The following risk factors are thought to be associated with coronary artery aneurysms:
- Individual's genetic make-up, especially in patients with congenital coronary artery aneurysms
- Coronary artery disease (atherosclerosis)
- Vasculitic and connective tissue diseases (Kawasaki and Marfan)
- Intracoronary manipulation leading to local wall stress (stent placement, angioplasty, brachytherapy)
- Post-infectious as a consequence of direct wall infiltration or immune complex deposition[8]
Diagnosis
It is often found coincidentally on
Treatment
Treatment for coronary artery aneurysm include medical management, surgery and percutaneous intervention. Underlying coronary artery risk factors should be addressed in patients with atherosclerosis and proper guideline-mediated medications should be started. In those with risk for embolism or thrombosis, anti-platelet or anticoagulation therapy should be contemplated.[2]
In patients with Kawasaki disease prompt administration of intravenous immunoglobulin (IVIG) therapy should be given to prevent complication of coronary artery aneurysm.[9]
Prognosis
Generally, it has a good prognosis.[3] In Kawasaki's disease, untreated, there is a 1–2% death rate, from cardiac causes.[citation needed]
The prognosis of coronary artery aneurysm is dependent on its diameter. The smaller the aneurysm the better the prognosis. There is less risk for ischemic myocardial damage and mortality with smaller aneurysms. Aneurysms with an internal diameter > 8 mm have poorer outcomes, since these aneurysms can be occluded and be associated with complications such as arrhythmias, myocardial infarction, or sudden death.[2]