PMID- 24084147
OWN - NLM
STAT- MEDLINE
DCOM- 20150828
LR  - 20220311
IS  - 1308-0032 (Electronic)
IS  - 1302-8723 (Linking)
VI  - 13
IP  - 7
DP  - 2013 Nov
TI  - Coronary artery ectasia as a culprit for acute myocardial infarction: review of 
      pathophysiology and management.
PG  - 695-701
LID - 10.5152/akd.2013.227 [doi]
AB  - Coronary artery ectasia (CAE) is defined as localized coronary dilatation, which 
      exceeds the diameter of normal adjacent segments or the diameter of the patient's 
      largest coronary vessel by 1.5 times. The pathophysiology of CAE remains unclear 
      as its relationship with atherosclerosis remains only modestly established. The 
      histological variances and conflicting reports of the role of traditional 
      cardiovascular risk factors, also, weakens the significance of such association. 
      The slow coronary flow (CSF) of CAE may lead to ischemic and thrombotic events, a 
      mechanism that has never been fully elucidated, but may play a fundamental role 
      in its pathogenesis. While pure, non-atherosclerotic, CAE is believed to have 
      better prognosis when compared to atherosclerotic obstructive CAE, it is thought 
      that CAE is not a simple condition but rather has an adverse clinical course. 
      Nevertheless, long-term prognosis and outcome of CAE is similar to 
      atherosclerotic-non-CAE. Since CAE was first described, oral anticoagulants have 
      been considered as a valid treatment option. Dual antiplatelet therapy is widely 
      employed in acute coronary syndrome (ACS), which also applies to CAE patients 
      presenting with ACS. However, there is a significant uncertainty about the best 
      treatment strategy for CAE in acute myocardial infarction. We hereby report a 
      variety of presentations of CAE complicated with ST elevation myocardial 
      infarction (STEMI). Pathophysiological and anatomical varieties of ectatic 
      coronary culprit lesions represent clinical challenges in uniformly managing this 
      condition. Our review is unique in critically showing the pathophysiology, 
      available controversial evidence upon management and prognostic features of CAE 
      with STEMI.
FAU - Boles, Usama
AU  - Boles U
AD  - Department of Public Health and Medicine, Heart Centre, Umea University, 
      Utmea-Sweden. bolesu@tcd.ie.
FAU - Rakhit, Roby
AU  - Rakhit R
FAU - Shiu, Man Fi
AU  - Shiu MF
FAU - Patel, Ketna
AU  - Patel K
FAU - Henein, Michael
AU  - Henein M
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20130926
PL  - Turkey
TA  - Anadolu Kardiyol Derg
JT  - Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology
JID - 101095069
SB  - IM
MH  - Coronary Artery Disease/complications/*physiopathology/prevention & control
MH  - Dilatation, Pathologic
MH  - Humans
MH  - Myocardial Infarction/complications/*physiopathology/prevention & control
EDAT- 2013/10/03 06:00
MHDA- 2015/09/01 06:00
CRDT- 2013/10/03 06:00
PHST- 2013/10/03 06:00 [entrez]
PHST- 2013/10/03 06:00 [pubmed]
PHST- 2015/09/01 06:00 [medline]
AID - 10.5152/akd.2013.227 [doi]
PST - ppublish
SO  - Anadolu Kardiyol Derg. 2013 Nov;13(7):695-701. doi: 10.5152/akd.2013.227. Epub 
      2013 Sep 26.