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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Coronary Artery Aneurysms and Acute Coronary Syndrome: An Interventionalist's Dilemma
Nauman Khalid1, Sundeep Kumar2, Preetham Muskula3
1Saint Francis Medical Center, Monroe, Louisiana, US.
Insights
Coronary artery aneurysms (CAA) can cause acute coronary syndrome, even without traditional risk factors. Managing these challenging cases involves various diagnostic and interventional strategies.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Coronary artery aneurysm (CAA) is a rare condition.
- CAA can present atypically, even in patients without traditional coronary artery disease risk factors.
Observation:
- Three adult cases of CAA presenting with acute coronary syndrome (ACS) are reported.
- Two patients lacked conventional risk factors for coronary artery disease.
Findings:
- CAA diagnosis utilizes angiography, intravascular ultrasound, and coronary computed tomography.
- Management strategies include medical therapy, stenting, coil embolization, and surgical exclusion.
Implications:
- This case series highlights the diagnostic and management challenges of CAA.
- Understanding CAA pathophysiology and risk factors is crucial for effective intervention.
Abstract:
We report three cases of coronary artery aneurysm (CAA) in adults who presented with acute coronary syndrome. Two of these patients did not have traditional coronary artery disease risk factors. Management of CAA poses a significant challenge to interventionalists. We discuss the etiologic mechanisms, risk factors, pathophysiology, and diagnosis using angiography, intravascular ultrasound, and coronary computed tomography. We also highlight management options, including medical therapy and catheter-based interventions such as stenting, coil embolization, stent-assisted coil embolization, and surgical exclusion.
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