Diagnosis and Management of Coronary Artery Ectasia: Insights from Clinical Picture, Angiographic Studies and Therapeutic Approaches: Review Article

Background: Coronary artery ectasia (CAE) is described as abnormal dilatation of coronary arteries above 1.5 times the adjacent normal segment diameter, often linked to disturbed flow, thrombosis, and inflammation. Affecting 1.2-7.4% of angiography patients, CAE presents heterogeneously from asymptomatic states to acute coronary syndromes, with complications like embolism, vasospasm, and rupture. Diagnosis relies on angiography, supplemented by IVUS, OCT, CT, MRI, and echocardiography, especially in Kawasaki disease-related cases. Objective: This article aimed to provide insights into the clinical presentation, diagnostic modalities, and therapeutic approaches for CAE, emphasizing angiographic findings and management strategies to improve case results. Methods: A narrative literature review was conducted utilizing peer-reviewed studies, systematic reviews, and reports from databases like PubMed and Science Direct. Focus was on angiographic diagnosis, complications, conservative and invasive treatments. Non-English, unpublished, or non-significant works were excluded. Conclusion: CAE diagnosis integrates invasive and noninvasive imaging for accurate vessel assessment and complication detection. Management is individualized: Conservative with antiplatelets, ACEIs, statins (avoiding nitrates), invasive via stents, coil embolization, thrombectomy, or surgery for high-risk features. Tailored therapies mitigate thrombosis and ischemia, though evidence gaps persist, warranting further research.