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Coronary artery ectasia is characterized by the enlargement of a coronary artery to 1.5 times or more than its normal diameter. [1] The disease is commonly asymptomatic and is normally discovered when performing tests for other conditions such as coronary artery disease, stable angina and other acute coronary syndromes.
The smaller the aneurysm the better the prognosis. There is less risk for ischemic myocardial damage and mortality with smaller aneurysms. Aneurysms with an internal diameter > 8 mm have poorer outcomes, since these aneurysms can be occluded and be associated with complications such as arrhythmias, myocardial infarction, or sudden death. [2]
The coronary arteries can constrict as a response to various stimuli, mostly chemical. This is known as a coronary reflex. There is also a rare condition known as spontaneous coronary artery dissection, in which the wall of one of the coronary arteries tears, causing severe pain. [10]
Aneurysms may affect the right (65–85%), non-coronary (10–30%), or rarely the left (< 5%) coronary sinus. [1] These aneurysms may not cause any symptoms but if large can cause shortness of breath, palpitations or blackouts. Aortic sinus aneurysms can burst or rupture into adjacent cardiac chambers, which can lead to heart failure if untreated.
The size and location put a person at risk of abnormal heart rhythms (arrhythmias) or heart block, aneurysm of the heart ventricles, inflammation of the heart wall following infarction, and rupture of the heart wall that can have catastrophic consequences. [72] [80] Injury to the myocardium also occurs during re-perfusion.
Fusiform aneurysms ("spindle-shaped" aneurysms) are variable in both their diameter and length; their diameters can extend up to 20 cm (7.9 in). They often involve large portions of the ascending and transverse aortic arch, the abdominal aorta, or, less frequently, the iliac arteries. [3]: 357
Ectasia (/ ɛ k ˈ t eɪ ʒ ə /), also called ectasis (/ ˈ ɛ k t ə s ɪ s /), is dilation or distention of a tubular structure, [1] either normal or pathophysiologic but usually the latter (except in atelectasis, where absence of ectasis is the problem).
Coronary ischemia can have serious consequences if it is not treated. Plaques in the walls of the coronary arteries can rupture, resulting in occlusion of the artery and deprivation of blood flow and oxygen to the heart muscle, resulting in cardiac cell death. [9] This is known as myocardial infarction. [9]