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The Coronary Arteries: Atherosclerosis and Ischaemic Heart Disease
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
The terms coronary artery aneurysm, aneurysmal dilatation and coronary ectasia are all used to describe different points in a continuum which runs from very localized saccular aneurysms to an artery in which stenosis alternates from widely dilated segments to diffuse dilatation. Localized aneurysms may be traumatic, congenital, post-inflammatory/post-Kawasaki disease. Pathologists are most likely to encounter coronary ectasia, which is relatively common in elderly subjects. In this condition, segments of the coronary artery dilate and have a large lumen, with diffuse atherosclerosis and calcification.
Test Paper 1
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
A 3-year-old presents as acutely unwell with a maculopapular rash, lymphadenopathy and erythema of her palms. Her white cell count is normal, and a specific cause for her symptoms is not found. She improves on immunoglobulins and supportive treatment. A follow-up echocardiogram shows cardiomegaly and a coronary artery aneurysm. What is the likely diagnosis? Takayasu arteritisKawasaki arteritisMoyamoya syndromeHenoch–Schonlein purpuraChurg–Strauss syndrome
Delayed intravenous immunoglobulin treatment increased the risk of coronary artery lesions in children with Kawasaki disease at different status
Published in Postgraduate Medicine, 2018
Huixian Qiu, Yuee He, Xing Rong, Yue Ren, Lulu Pan, Maoping Chu, Rongzhou Wu, Hongying Shi
The diagnosis of CALs is based on the following three criteria: (1) coronary artery diameter >2.5 mm in children <3 years old, >3mm in children aged 3–9 years, and >3.5 mm in children older than 9 years; as well as diameter of one segment of coronary artery more than 1.5 times that of adjacent segment; (2) coronary artery aneurysm: ratio of the diameter of the coronary artery to the adjacent segment > 1.5, and diameter of the coronary artery >4 mm. Small, medium, and giant coronary artery aneurysm are defined based on the coronary artery diameter: <5, 5–8, and >8, respectively; (3) coronary artery stenosis and embolism: coronary artery diameter reduction, irregular and asymmetric tube wall or irregularity and interruption of the lumen of the continuous non-echo area.
A giant coronary artery ectasia successfully managed conservatively
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Waqas Ullah, Mishal Shaukat, Asrar Ahmad, Zain Ali, Maryam Mukhtar, Mamoon Ur Rashid
Coronary artery aneurysm (CAA) is defined as a localized luminal dilation measuring at least 1.3 to 2 times the diameter of a normal coronary artery. The reported prevalence of CAA ranges from 1.9% to 10% [1]. Coronary artery aneurysm predominantly affects the male population, with a male to female ratio of 3:1. Patients with CAA are at an increased risk of having distal coronary artery embolization due to turbulent blood flow. Most cases in the literature are managed with a revascularization approach (coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI). In the present study, we have identified factors responsible for severe ectasias and an approach towards its management.
Epidemiology of primary systemic vasculitis in children: a population-based study from southern Sweden
Published in Scandinavian Journal of Rheumatology, 2018
M Mossberg, M Segelmark, R Kahn, M Englund, AJ Mohammad
Fifty-six patients met the diagnosis criteria for KD. The median diagnosis delay was 7 days (IQR 5.25–8.75, range 2–17 days). The disease onset was in children under the age of 5 years in 44 cases (52% male) (Figure 3B). The estimated incidence rate was 55 (95% CI 38.8–71.3) per million children aged less than 5 years. The median age at diagnosis was 1.5 years (IQR 0–2.75, range 0–16 years). Nine cases (16%) developed coronary artery aneurysm. A seasonal variation was seen in KD, with no diagnosed cases in June and July (Figure 4B).