Coronary arterial ectasia

Last revised by Yuranga Weerakkody on 5 Jul 2022

Coronary arterial ectasia (CAE) refers to diffuse dilatation of the coronary arteries. Under some classification systems, there is some overlap with the term coronary arterial aneurysms (which is a more focal dilatation).

It is often defined as dilatation of an arterial segment to a diameter at least 1.5 times (i.e. 150%) that of the adjacent normal coronary artery (unaffected segment) and involves at least 50% or more of the length of the artery 1.

They may be present in up to ~5% (range 3-8%) of angiographic and in ~1% (range 0.2-1.4%) of autopsy series.

It is attributed to atherosclerosis in 50% of patients while in ~25% of patients it may be congenital in origin.

One method of classification is 1:

  • type I: diffuse ectasia of two or three vessels
  • type II: diffuse ectasia of one vessel and localized disease in other, i.e. an aneurysm
  • type III: diffuse ectasia in only one vessel
  • type IV: focal coronary aneurysm in one vessel

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