Reviewed By: Pramod Kerkar, MD, FFARCSI

Characterized by the dilatation of coronary arteries by 1.5 times as compared to the normal artery, coronary ectasia lead to reduced blood flow to the cardiac muscles. It may also increase the risk of bleeding and may cause aneurysm.

What Is Coronary Ectasia?

Coronary ectasia is a disease characterized by the dilatation of coronary artery by at least 1.5 times to its normal diameter. The exact reason for the disease is not known but the occurrence of the disease involves common risk factors that are present in the coronary artery disease. Further, the disease involves the vascular endothelium and the thickening of the vessel wall. The disease is generally asymptomatic and is usually diagnosed during the diagnosis of other cardiac conditions such as coronary artery disease and angina. The coronary ectasia also increases the risk of rupturing the coronary arteries, a condition known as aneurysm, which is a life-threatening condition. It is generally present in the patient with coronary atherosclerosis and also connected with the patients suffering from scleroderma, a connective tissue disorder. The condition of coronary ectasia may either be congenital or acquired. The increase in diameter of the vessel reduces the flow of the blood leading to chest pain and spasm. If the cardiac muscles are deprived of the blood for too long, permanent damage may occur.

Risk Factors For Coronary Ectasia

Gender: The men are almost 4 times more prone to coronary ectasia as compared to women.

Smoking: Smoking is the major contributor of any cardiac disease and coronary ectasia is also not an exception. Smokers are believed to be at higher risk of coronary ectasia as compared to non-smokers.

Heart Disease: Most of the cases of coronary ectasia are diagnosed when the patient is suffering from other heart disease such as coronary syndrome or angina. Thus, patients with heart disease are at higher risk when compared to the people without any heart disease.

Coronary Ectasia Diagnosis

X-ray Coronary Angiography: It is technique in the diagnosis of coronary ectasia and is used to identify the vessel wall changes in the coronary ectasia. It is done by using a contrast media or dye and the flow of dye is calculated with this process. This include delay in flow, back flow or the deposition of dye on the dilated vessel. This technique also helps in analyzing the change in the diameter of the vessel wall.

Coronary Artery Computed Tomography (CACT): As this technique requires high doses of radiation, which may lead to other complications, this is not a technique-of-choice for the patients requiring frequent evaluation. However, this is an important technique to identify the changes in the vessels such as increase in diameter.

Magnetic Resonance Angiography (MRA): Better than the X-ray coronary angiography, this technique provides an excellent three-dimensional image of the coronary artery. This technique may or may not use contrast media and if the contrast media is chosen, it does not have the potential to cause allergic reaction as sometimes seen with other contrast media. Further, this technique does not use any ionizing radiations such as X-ray.

Blood Tests: The preliminary identification of the coronary ectasia may be done through the blood test which contains various diagnostic markers. These diagnostic markers may include TNF-alpha, C-reactive protein, IL-6 and cell adhesion molecules.

Treatment For Coronary Ectasia

As the risk associated with this disease and the features presented are similar to other cardiac anomalies, thus the treatment is almost similar to other cardiac disease such as atherosclerosis and coronary artery disease. Apart from the drugs, the medical devices are also used, such as balloon expandable stent, for the management of coronary ectasia. The anticoagulant therapy including warfarin and aspirin and the anti-spasmodic therapy including calcium channel blockers are prescribed in this disease.

Conclusion

Coronary ectasia is the increase in diameter of coronary artery. This leads to reduced supply of blood in cardia muscles, resulting in pain and spasm. The treatment is generally done with the drugs such as anticoagulants and may also include the use of medical devices to reduce the risk.

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: December 1, 2018

This article does not provide medical advice. See disclaimer

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