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ST-Elevation Myocardial Infarction in Coronary Ectasia: A Case Report Choi, Hye Ji (Sally); Luong, Christina; Fung, Anthony; Tsang, Teresa S. M.

Abstract

Coronary artery ectasia (CAE) is localized or diffuse dilatation of the coronary artery lumen exceeding the diameter of adjacent healthy reference segments by 1.5 times. It is a rare phenomenon and incidence ranges from 1 to 5% in patients undergoing angiography. We report a case of a 58-year-old man with atherosclerotic CAE who experienced ST-elevation myocardial infarction (STEMI) despite prophylactic antiplatelet therapy. He was successfully treated with IV eptifibatide and aspiration thrombectomy. We reviewed the literature of CAE presentation, etiology and treatment and discussed the most appropriate antithrombotic therapy to prevent STEMIs in patients with CAE. While the current literature appears to favour prophylactic antiplatelet and anticoagulant in these patients, more studies are needed to determine the optimal form and duration of antithrombotic therapy. Currently, there is no gold standard treatment for CAE and further prospective and randomized-controlled studies are needed to guide recommendations.

Item Metadata

Title
ST-Elevation Myocardial Infarction in Coronary Ectasia: A Case Report
Creator
Choi, Hye Ji (Sally); Luong, Christina; Fung, Anthony; Tsang, Teresa S. M.
Publisher
Multidisciplinary Digital Publishing Institute
Date Issued
2018-11-16
Description
Coronary artery ectasia (CAE) is localized or diffuse dilatation of the coronary artery lumen exceeding the diameter of adjacent healthy reference segments by 1.5 times. It is a rare phenomenon and incidence ranges from 1 to 5% in patients undergoing angiography. We report a case of a 58-year-old man with atherosclerotic CAE who experienced ST-elevation myocardial infarction (STEMI) despite prophylactic antiplatelet therapy. He was successfully treated with IV eptifibatide and aspiration thrombectomy. We reviewed the literature of CAE presentation, etiology and treatment and discussed the most appropriate antithrombotic therapy to prevent STEMIs in patients with CAE. While the current literature appears to favour prophylactic antiplatelet and anticoagulant in these patients, more studies are needed to determine the optimal form and duration of antithrombotic therapy. Currently, there is no gold standard treatment for CAE and further prospective and randomized-controlled studies are needed to guide recommendations.
Subject
Coronary artery ectasia; STEMI; Atherosclerosis; Case report
Genre
Article
Type
Text
Language
eng
Date Available
2019-06-13
Provider
Vancouver : University of British Columbia Library
Rights
CC BY 4.0
DOI
10.14288/1.0379430
URI
http://hdl.handle.net/2429/70638
Affiliation
Medicine, Faculty of; Non UBC; Medicine, Department of
Citation
Diseases 6 (4): 104 (2018)
Publisher DOI
10.3390/diseases6040104
Peer Review Status
Reviewed
Scholarly Level
Faculty
Rights URI
https://creativecommons.org/licenses/by/4.0/
Aggregated Source Repository
DSpace

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CC BY 4.0