Coronary artery vasculitis: a review of current literature

Area of Science:

• Cardiology
• Immunology
• Radiology

Background:

• Cardiac vasculitis presents diversely, including pericarditis, myocarditis, and valvular heart disease.
• Coronary artery vasculitis (CAV) is an emerging condition affecting younger populations, differing from atherosclerosis.
• CAV can lead to serious complications such as coronary aneurysms, stenosis, thrombosis, and acute coronary syndromes.

Purpose of the Study:

• To review the spectrum of cardiac vasculitis, focusing on coronary artery vasculitis (CAV).
• To highlight the diagnostic role of multi-modality imaging in CAV.
• To discuss current treatment strategies and the need for further research.

Main Methods:

• Literature review of cardiac vasculitis and CAV.
• Emphasis on multi-modality imaging techniques for diagnosis.
• Discussion of pharmacological, interventional, and surgical management approaches.

Main Results:

• CAV has multiple etiologies, including Kawasaki disease, Takayasu's arteritis, Polyarteritis Nodosa, and Giant-Cell Arteritis.
• Multi-modality imaging (echocardiography, CMR, CTCA, PET, conventional angiography with IVUS) aids diagnosis.
• Treatment involves varied immunosuppressive and anti-platelet therapies, with interventional/surgical options for select cases.

Conclusions:

• CAV is a significant cause of cardiac morbidity, particularly in younger individuals.
• A multi-disciplinary approach integrating advanced imaging and tailored therapies is essential for managing CAV.
• Further large-scale studies are needed to refine management protocols for this specific patient group.