Figure 1
Resting electrocardiogram at admission. Sinus rhythm, 70 bpm; QRS axis, +60°; ST segment elevation DII, DIII, aVF, V7–V9 with reciprocal ST segment depression in V1–V3, aVL.
Figure 2
Left anterior oblique projection of the right coronary artery. Significantly dilated right coronary artery (RCA) on its entire length, seen in left anterior oblique projection. Arrows indicate high quantity of thrombotic material in the mid-distal RCA.
Figure 3
Cranial right anterior oblique projection of the left coronary artery. Optimal projection of the left anterior descending artery (LAD) showing an ectatic vessel, with a maximum diameter of 7.4 mm in the proximal segment.
Figure 4
Caudal left anterior oblique projection of the left coronary artery. “Spyder” projection shows ectasia of the left main coronary artery (maximum diameter of 10.3 mm in the mid-distal portion) and left circumflex (maximum diameter of 8.5 mm in the proximity of the ostium).
Figure 5
Left anterior oblique projection of the right coronary artery—1 month later. One month later, there is no evidence of thrombus in the right coronary artery, and there is a moderate stenosis in the distal segment.
Figure 6
Cranial right anterior oblique projection of the left anterior descending artery—1 month later. In this projection, the left anterior descending artery can be seen, with ectasia on the entire length and a lack of significant atherosclerosis.
Figure 7
Postero-anterior caudal projection of the left coronary artery—1 month later. This view optimally projects the left main coronary artery (mid-distal segment) and the left circumflex, in which no significant atherosclerotic lesions are seen. Note also the diffuse ectasia present in both arteries.
Table 1
Coronary artery ectasia etiology. ANCA, antineutrophilic cytoplasmic antibody; KCNH1, member 1 of H subfamily of voltagegated potassium channel; ATG16L1, autophagia related 16 like 1; PCI, percutaneous coronary intervention
| Etiology | Frequency |
|---|---|
| Atherosclerosis | 50% (19) |
| Smoking | (19) |
| Arterial hypertension | (19) |
Congenital:
| 20%-30% (6, 19, 70) |
Inflammatory diseases:
Connective tissue disorders:
| 10%-20% (10,19, 38, 67, 70, 71,136-140) |
| Cardiac lymphoma | (141) |
Infectious:
| (70, 142) |
| Hypertrophic cardiomyopathy | (24) |
Genetic factors:
| (19, 30, 113, 143-145) |
| Cocaine usage | (146) |
Iatrogenic:
| (25, 70) |