Coronary Artery Ectasia

This review on coronary artery ectasia (CAE) explores what is currently known about its classification, etiology and pathogenesis, clinical manifestations, methods of diagnosis, treatment and prognosis. CAE is not a rare coronary anomaly. Its prevalence is about 0.3–12% in autopsies and during coronary angiography or multidetector computed tomography (MDCT). Its etiology is varied and its pathophysiology is not completely understood. More than half of CAE cases is due to coronary atherosclerosis, and the right coronary artery is most commonly affected. Angina pectoris is the most common clinical manifestation. Unstable angina, acute myocardial infarction, heart failure, ventricular tachycardia/fibrillation, and sudden death have also been reported. Myocardial ischemia is possibly caused by coexisting significant coronary stenosis, slow flow, microvascular dysfunction, thrombus formation, coronary spasm or spontaneous coronary dissection. Coronary angiography, intravascular ultrasound, and MDCT are the current major diagnostic tools for CAE. The prognosis of CAE has shown improvement when it is treated with aggressive medical therapy, modern revascularization techniques, and state-of-the-art equipment.