Acute myocardial infarction secondary to coronary artery ectasia and right coronary artery agenesis

Infarto agudo de miocardio secundario a enfermedad coronaria ectásica y agenesia de la arteria coronaria derecha

We present the case of a 42-year-old male patient with acute myocardial infarction without ST-segment elevation, in whom moderate to severe ectopic coronary disease is documented and as an incidental finding agenesis of the right coronary artery. . A rare entity, a review is made of the most relevant aspects of the literature on coronary ectasia and a brief description of the incidental finding.

1. Devabhaktuni S, Mercedes A, Diep J, Ahsan C. Coronary Artery Ectasia-A Review of Current Literature. Curr Cardiol Rev. 2016;12(4):318-23. doi: 10.2174/1573403X12666160504100159
2. Sorrell VL, Davis MJ, Bove AA. Current knowledge and significance of coronary artery ectasia: a chronologic review of the literature, recommendations for treatment, possible etiologies, and future considerations. Clin Cardiol. 1998;21(3):157-60. doi: 10.1002/clc.4960210304
3. Eitan A, Roguin A. Coronary artery ectasia: new insights into pathophysiology, diagnosis, and treatment. Coron Artery Dis. 2016;27(5):420-8. doi: 10.1097/MCA.0000000000000379
4. Antoniadis AP, Chatzizisis YS, Giannoglou GD. Pathogenetic mechanisms of coronary ectasia. Int J Cardiol. 2008;130(3):335-43. doi: 10.1016/j.ijcard.2008.05.071
5. Zografos TA, Korovesis S, Giazitzoglou E, Kokladi M, Venetsanakos I, Paxinos G, et al. Clinical and angiographic characteristics of patients with coronary artery ectasia. Int J Cardiol. 2013;167(4):1536-41. doi: 10.1016/j.ijcard.2012.04.098
6. Turhan H, Yetkin E. Coronary artery ectasia: Is it a destructive inflammatory lesion of the vascular wall? Int J Cardiol. 2007;118(2):241. doi: https://doi.org/10.1016/j.ijcard.2006.07.009
7. Ozcan OU, Gulec S. Coronary artery ectasia. Cor et Vasa. 2013;55(3):e242-e7. doi: https://doi.org/10.1016/j. crvasa.2013.01.003
8. Kabde SS, Borikar N, Nalawde D, Dhanwale SS, Bedmuthiya K, Jindal S, et al. Clinical profie and short term follow up of patients with coronary artery ectasia. Indian Heart J. 2014;66:S32. doi: https://doi.org/10.1016/j.ihj.2014.10.090
9. Ilgenli TF, Acikalin A, Turkmen S, Avci A, Akpinar O. ST elevation in inferior derivation, coronary ectasia, and slow coronary flow following ceftriaxone use. Am J Emerg Med. 2012;30(8):1657 e5-7. doi: 10.1016/j.ajem.2011.08.004
10. Brunetti ND, Salvemini G, Cuculo A, Ruggiero A, De Gennaro L, Gaglione A, et al. Coronary artery ectasia is related to coronary slow flow and inflammatory activation. Atherosclerosis. 2014;233(2):636-40. doi: 10.1016/j.atherosclerosis.2014.01.018
11. Boles U, Rakhit R, Shiu MF, Patel K, Henein M. Coronary artery ectasia as a culprit for acute myocardial infarction: review of pathophysiology and management. Anadolu Kardiyol Derg. 2013;13(7):695-701. doi: 10.5152/akd.2013.227
12. Antonopoulos AS, Siasos G, Oikonomou E, Mourouzis K, Mavroudeas SE, Papageorgiou N, et al. Characterization of vascular phenotype in patients with coronary artery ectasia: The role of endothelial dysfunction. Int J Cardiol. 2016;215:138-9. doi: 10.1016/j.ijcard.2016.04.046
13. Tuncer C, Sokmen G, Sokmen A, Suner A. Diffuse coronary ectasia and intracoronary thrombus involving left circumflex coronary artery and presenting as acute coronary syndrome: report of two cases. Int J Cardiol. 2008;128(1):e25-7. doi: 10.1016/j. ijcard.2007.04.158
14. Vasu N, Narayanan S, Ajit MS. Clinical outcome of various management strategies in coronary artery ectasia. Indian Heart J. 2017;69(3):319-21. doi: 10.1016/j.ihj.2017.04.013
15. Amin AS, Hoseyni Guyomi S, Buijs EM, De Milliano PA. Coronary ectasia and repeated myocardial infarction in a young man. Int J Cardiol. 2014;171(3):e74-5. Doi: 10.1016/j.ijcard.2013.11.102
16. Wehbe MS, Schroeter T. Mega Coronary Arteries. Ann Thorac Surg. 2016;101(1):367. doi: 10.1016/j.athoracsur.2015.09.042
17. Hernández F, García Tejada J, Pindado C, Tascón JC. Arteria coronaria única y agenesia del ostium derecho. Rev Esp Cardiol. 2000;53(10):1398.
18. Barriales Villa R, López Muñiz A, Hernández LC, San Román L, de la Hera JM, Morís C, et al. Anomalías congénitas de las arterias coronarias del adulto descritas en 31 años de estudios coronariográficos en el Principado de Asturias: principales características angiográficas y clínicas. Rev Esp Cardiol. 2001;54(3):269-81. doi: https://doi.org/10.1016/S0300- 8932(01)76308-7
19. Lipton MJ, Barry WH, Obrez I, Silverman JF, Wexler L. Isolated single coronary artery: diagnosis, angiographic classification, and clinical significance. Radiology. 1979;130(1):39-47. doi: 10.1148/130.1.39
20. Liu H, Guo X, Wang C, Li S, Shi Y. Congenital absence of the right coronary artery with superdominant left circumflex coronary artery. Int J Cardiol. 2012;158(1):e13-4. doi: 10.1016/j. ijcard.2011.10.049