Coronary Artery Aneurysms As a Cause of Acute Coronary Syndrome Presentation - A Focused Review

Overview

Journal Curr Cardiol Rev

Publisher Bentham Science Publishers

Specialty Cardiology & Vascular Diseases

Date 2023 Mar 31

PMID 36999696

Authors

Azka Latif

Amy Tran

Junaid Ahsan

Noman Lateef

Waiel Abusina

Vikas Kapoor

Zoraiz Ahsan

Soban Ahmad

Mohsin Mirza

Affiliations

Soon will be listed here.

Abstract

Coronary artery aneurysms (CAA) are defined as a dilation of a coronary vessel greater than 1.5 times the diameter of a local reference vessel. While CAAs tend to be incidental findings on imaging, they result in complications, such as thrombosis, embolization, ischemia, arrhythmias, and heart failure. Among symptomatic cases, chest pain has been the most common manifestation of CAAs. This necessitates an understanding of CAAs as a cause of acute coronary syndrome (ACS) presentation. However, due to the unclear pathophysiology of CAAs and their variable presentation complicated by similar ACS conditions, there is no clear strategy for CAA management. In this article, we will discuss the contribution of CAAs to ACS presentations and review the current management options for CAAs.

References

Crawley P, Mahlow W, Huntsinger D, Afiniwala S, Wortham D . Giant coronary artery aneurysms: review and update. Tex Heart Inst J. 2015; 41(6):603-8. PMC: 4251331. DOI: 10.14503/THIJ-13-3896. View

Hong S, Kim H, Ahn C, Kim J, Kim B, Ko Y . Coronary Artery Aneurysm after Second-Generation Drug-Eluting Stent Implantation. Yonsei Med J. 2019; 60(9):824-831. PMC: 6704022. DOI: 10.3349/ymj.2019.60.9.824. View

Aoki J, Kirtane A, Leon M, Dangas G . Coronary artery aneurysms after drug-eluting stent implantation. JACC Cardiovasc Interv. 2009; 1(1):14-21. DOI: 10.1016/j.jcin.2007.10.004. View

Joo H, Yu C, Choi R, Park J, Lee H, Kim J . Clinical outcomes of patients with coronary artery aneurysm after the first generation drug-eluting stent implantation. Catheter Cardiovasc Interv. 2017; 92(3):E235-E245. DOI: 10.1002/ccd.27429. View

Satou G, Giamelli J, Gewitz M . Kawasaki disease: diagnosis, management, and long-term implications. Cardiol Rev. 2007; 15(4):163-9. DOI: 10.1097/CRD.0b013e31802ea93f. View

Boles U, Rakhit R, Shiu M, Patel K, Henein M . Coronary artery ectasia as a culprit for acute myocardial infarction: review of pathophysiology and management. Anadolu Kardiyol Derg. 2013; 13(7):695-701. DOI: 10.5152/akd.2013.227. View

Taskesen T, Osei K, Ugwu J, Hamilton R, Tannenbaum M, Ghali M . Coronary artery aneurysm presenting as acute coronary syndrome: two case reports and a review of the literature. J Thromb Thrombolysis. 2021; 52(2):683-688. DOI: 10.1007/s11239-021-02418-2. View

Latt H, Aung S, Kyaw K, Seher R . Coronary artery ectasia presenting with acute inferior wall myocardial infarction in a young adult. J Community Hosp Intern Med Perspect. 2017; 7(4):262-264. PMC: 5637702. DOI: 10.1080/20009666.2017.1369376. View

Aqel R, Zoghbi G, Iskandrian A . Spontaneous coronary artery dissection, aneurysms, and pseudoaneurysms: a review. Echocardiography. 2004; 21(2):175-82. DOI: 10.1111/j.0742-2822.2004.03050.x. View

10.

Kim U, Seol S, Kim D, Kim D, Jang J, Yang T . Clinical outcomes and the risk factors of coronary artery aneurysms that developed after drug-eluting stent implantation. Circ J. 2011; 75(4):861-7. DOI: 10.1253/circj.cj-10-0635. View

11.

Kawsara A, Nunez Gil I, Alqahtani F, Moreland J, Rihal C, Alkhouli M . Management of Coronary Artery Aneurysms. JACC Cardiovasc Interv. 2018; 11(13):1211-1223. DOI: 10.1016/j.jcin.2018.02.041. View

12.

Nunez-Gil I, Terol B, Feltes G, Nombela-Franco L, Salinas P, Escaned J . Coronary aneurysms in the acute patient: Incidence, characterization and long-term management results. Cardiovasc Revasc Med. 2017; 19(5 Pt B):589-596. DOI: 10.1016/j.carrev.2017.12.003. View

13.

Monem M, Rampat R . An unusual cause of ST elevation myocardial infarction (STEMI). BMJ Case Rep. 2014; 2014. PMC: 4173268. DOI: 10.1136/bcr-2014-203981. View

14.

Stone G, Ellis S, Cannon L, Mann J, Greenberg J, Spriggs D . Comparison of a polymer-based paclitaxel-eluting stent with a bare metal stent in patients with complex coronary artery disease: a randomized controlled trial. JAMA. 2005; 294(10):1215-23. DOI: 10.1001/jama.294.10.1215. View

15.

Sherif S, Ozden Tok O, Taskoylu O, Goktekin O, Dogu Kilic I . Coronary Artery Aneurysms: A Review of the Epidemiology, Pathophysiology, Diagnosis, and Treatment. Front Cardiovasc Med. 2017; 4:24. PMC: 5418231. DOI: 10.3389/fcvm.2017.00024. View

16.

Swaye P, Fisher L, Litwin P, Vignola P, JUDKINS M, Kemp H . Aneurysmal coronary artery disease. Circulation. 1983; 67(1):134-8. DOI: 10.1161/01.cir.67.1.134. View

17.

Alfonso F, Perez-Vizcayno M, Ruiz M, Suarez A, Cazares M, Hernandez R . Coronary aneurysms after drug-eluting stent implantation: clinical, angiographic, and intravascular ultrasound findings. J Am Coll Cardiol. 2009; 53(22):2053-60. DOI: 10.1016/j.jacc.2009.01.069. View

18.

Slota P, Fischman D, Savage M, RAKE R, Goldberg S . Frequency and outcome of development of coronary artery aneurysm after intracoronary stent placement and angioplasty. STRESS Trial Investigators. Am J Cardiol. 1997; 79(8):1104-6. DOI: 10.1016/s0002-9149(97)00055-6. View

19.

Jeudy J, White C, Kligerman S, Killam J, Burke A, Sechrist J . Spectrum of Coronary Artery Aneurysms: From the Radiologic Pathology Archives. Radiographics. 2018; 38(1):11-36. DOI: 10.1148/rg.2018170175. View

20.

Khubber S, Chana R, Meenakshisundaram C, Dhaliwal K, Gad M, Kaur M . Coronary artery aneurysms: outcomes following medical, percutaneous interventional and surgical management. Open Heart. 2021; 8(1). PMC: 7878141. DOI: 10.1136/openhrt-2020-001440. View