Analysis of Coronary Artery Ectasia: Experience from a Tertiary Care Hospital in South India

Background: Coronary artery ectasias (CAE) could have a prediction for coronary artery disease (CAD). Ectatic coronary arteries even without the presence of coronary stenoses are subject to thrombus formation, vasospasm, and spontaneous dissection. The presence of ectatic segments produces sluggish blood flow, with exercise-induced angina and myocardial infarction, regardless of the severity of coexisting stenotic coronary disease. Objectives: The present study was done to analyze the incidence of CAE and to check the association of CAE with CAD. Methods: This was a retrospective study of 7148 patients who had coronary angiogram from 2010 to 2015. Details of the patients and clinical symptoms were analyzed. Electrocardiography was evaluated for various abnormalities. The treadmill test was performed utilizing modified Bruce protocol. The angiogram films were reviewed with two blinded observers. Results: 257 patients had angiographic evidence of CAE. The most commonly affected vessel was the right coronary artery (88.73%) followed by a left anterior descending artery (41.63%), left circumflex artery (28.79%), and left main coronary artery (5.45%). The most common type of ectasia seen was Type IV ectasia (80%) followed by Type III (9%) and Type II (8%). Lowest percentage distribution (3%) was seen among Type I group. The greater incidence of ectasia was seen in the proximal segment of the coronary arteries compared to the distal segment. Conclusion: Coronary ectasia can cause flow limiting obstructive lesions and could have guarded prognosis in view of its propensity of layered thrombus formation.