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Coronary artery aneurysm: a review
Progress in Cardiovascular Diseases
|July 1, 1997
Summary
Coronary artery aneurysms, uncommon dilations of coronary arteries, are increasingly diagnosed. Management decisions for coronary artery aneurysms depend on associated stenosis, with surgery recommended for severe cases and medical therapy for most.
Area of Science:
- Cardiology
- Vascular Medicine
Background:
- Coronary artery aneurysm (CAA) is defined as a dilation exceeding 1.5 times the adjacent segment or largest vessel diameter.
- CAA is uncommon, with increasing diagnoses due to coronary angiography advancements.
- Incidence ranges from 1.5% to 5%, predominantly in males, often affecting the right coronary artery.
Purpose of the Study:
- To review the definition, incidence, causes, complications, and management controversies of coronary artery aneurysms.
- To provide recommendations for surgical versus medical management strategies for CAA.
Main Methods:
- Literature review of coronary artery aneurysm.
- Analysis of diagnostic trends and etiological factors, primarily atherosclerosis.
- Evaluation of reported complications and treatment outcomes.
Main Results:
- Atherosclerosis is the leading cause (50%) of CAA in adults.
- Complications include thrombosis, distal embolization, rupture, and vasospasm.
- The natural history and prognosis of CAA remain unclear, with ongoing debate on optimal management.
Conclusions:
- Surgical intervention for CAA is recommended based on the severity of associated coronary stenosis, not solely on aneurysm presence.
- Medical therapy, including antiplatelet and anticoagulant medications, is indicated for the majority of patients with CAA.
- Further research is needed to clarify the natural history and long-term prognosis of coronary artery aneurysms.