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The Simultaneity of Coronary Artery Ectasia and Intracranial Arterial Dolichoectasia: A Rare Case Report

In the present study, we report a case of multiple coronary artery ectasias (CAE) and multiple intracranial arterial dolichoectasias (IADEs). A 60-year-old female presented to the emergency department twice with chest pain and mild elevation of troponin and T-wave changes. Peripheral coronary angiog...

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Autores principales: Alataby, Harith Adnan, Freg, George, Alzakhari, Rana, Atteya, Gourg, Dougar, Muhamed, Gala, Bhavesh, Nfonoyim, Jay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383699/
https://www.ncbi.nlm.nih.gov/pubmed/34434302
http://dx.doi.org/10.14740/jmc3390
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author Alataby, Harith Adnan
Freg, George
Alzakhari, Rana
Atteya, Gourg
Dougar, Muhamed
Gala, Bhavesh
Nfonoyim, Jay
author_facet Alataby, Harith Adnan
Freg, George
Alzakhari, Rana
Atteya, Gourg
Dougar, Muhamed
Gala, Bhavesh
Nfonoyim, Jay
author_sort Alataby, Harith Adnan
collection PubMed
description In the present study, we report a case of multiple coronary artery ectasias (CAE) and multiple intracranial arterial dolichoectasias (IADEs). A 60-year-old female presented to the emergency department twice with chest pain and mild elevation of troponin and T-wave changes. Peripheral coronary angiography showed severe ectasia and stenosis of certain segments of the left main coronary artery (LMCA), left anterior descending (LAD), first obtuse marginal (OM1), distal left circumflex (LCX), and bilateral subclavian arteries. The patient was treated medically. Two weeks later, she presented with dizziness. Head computerized tomography (CT) angiography showed severe IADE involving the vertebrobasilar system, intracranial internal carotid arteries, and bilateral middle cerebral arteries. No neurovascular intervention was performed due to the complexity of the findings. CAE is an abnormal dilatation of a coronary artery segment of at least 1.5 times the size of a normal coronary artery. The slow flow phenomenon may lead to ischemia and thrombosis, which can result in acute coronary syndrome. IADE comprises a dilatation and elongation of the arteries that affects both the anterior and posterior cerebral circulation, often causing neurological complications such as ischemic stroke, intracranial hemorrhage, or compression of surrounding neural structures. We report this case due to the rarity of coexisting IADE and CAE. A rarefaction of elastic tissue of the media with degeneration of the internal elastic lamina, in addition to matrix metalloproteinase dysfunction, is a common pathological mechanism for this condition. The management of CAE and IADE is mostly conservative, essentially treating the risk factors and administering antiplatelet and anticoagulant agents. In some patients, angioplasty vs. surgical treatment may be applied.
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spelling pubmed-83836992021-08-24 The Simultaneity of Coronary Artery Ectasia and Intracranial Arterial Dolichoectasia: A Rare Case Report Alataby, Harith Adnan Freg, George Alzakhari, Rana Atteya, Gourg Dougar, Muhamed Gala, Bhavesh Nfonoyim, Jay J Med Cases Case Report In the present study, we report a case of multiple coronary artery ectasias (CAE) and multiple intracranial arterial dolichoectasias (IADEs). A 60-year-old female presented to the emergency department twice with chest pain and mild elevation of troponin and T-wave changes. Peripheral coronary angiography showed severe ectasia and stenosis of certain segments of the left main coronary artery (LMCA), left anterior descending (LAD), first obtuse marginal (OM1), distal left circumflex (LCX), and bilateral subclavian arteries. The patient was treated medically. Two weeks later, she presented with dizziness. Head computerized tomography (CT) angiography showed severe IADE involving the vertebrobasilar system, intracranial internal carotid arteries, and bilateral middle cerebral arteries. No neurovascular intervention was performed due to the complexity of the findings. CAE is an abnormal dilatation of a coronary artery segment of at least 1.5 times the size of a normal coronary artery. The slow flow phenomenon may lead to ischemia and thrombosis, which can result in acute coronary syndrome. IADE comprises a dilatation and elongation of the arteries that affects both the anterior and posterior cerebral circulation, often causing neurological complications such as ischemic stroke, intracranial hemorrhage, or compression of surrounding neural structures. We report this case due to the rarity of coexisting IADE and CAE. A rarefaction of elastic tissue of the media with degeneration of the internal elastic lamina, in addition to matrix metalloproteinase dysfunction, is a common pathological mechanism for this condition. The management of CAE and IADE is mostly conservative, essentially treating the risk factors and administering antiplatelet and anticoagulant agents. In some patients, angioplasty vs. surgical treatment may be applied. Elmer Press 2019-11 2019-12-08 /pmc/articles/PMC8383699/ /pubmed/34434302 http://dx.doi.org/10.14740/jmc3390 Text en Copyright 2019, Alataby et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Alataby, Harith Adnan
Freg, George
Alzakhari, Rana
Atteya, Gourg
Dougar, Muhamed
Gala, Bhavesh
Nfonoyim, Jay
The Simultaneity of Coronary Artery Ectasia and Intracranial Arterial Dolichoectasia: A Rare Case Report
title The Simultaneity of Coronary Artery Ectasia and Intracranial Arterial Dolichoectasia: A Rare Case Report
title_full The Simultaneity of Coronary Artery Ectasia and Intracranial Arterial Dolichoectasia: A Rare Case Report
title_fullStr The Simultaneity of Coronary Artery Ectasia and Intracranial Arterial Dolichoectasia: A Rare Case Report
title_full_unstemmed The Simultaneity of Coronary Artery Ectasia and Intracranial Arterial Dolichoectasia: A Rare Case Report
title_short The Simultaneity of Coronary Artery Ectasia and Intracranial Arterial Dolichoectasia: A Rare Case Report
title_sort simultaneity of coronary artery ectasia and intracranial arterial dolichoectasia: a rare case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8383699/
https://www.ncbi.nlm.nih.gov/pubmed/34434302
http://dx.doi.org/10.14740/jmc3390
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