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BackgroundIsolated Coronary artery ectasia (CAE) is considered an uncommon angiographic finding with varying patterns of presentation and carries significant morbidity burden to the patient. Our objective was to evaluate the prevalence of this condition, to analyse its clinical, angiographic, and follow up characteristics.Patients and methodsCoronary angiography was performed in 4950 patients from January 2009 to August 2014. The epidemiological, clinical, angiographic, and follow up characteristics of 52 patients with isolated CAE were examined.ResultsOf the 4950 angiograms analysed, isolated CAE was found in 52 patients, a prevalence of 1.05 %. The mean age of patients was 53.4 years. A predominance of the male sex was observed (71.1%). Angina on exertion was the most common presenting symptom (61.5%). Single vessel was involved in 61.5%. Left anterior descending artery was the most commonly involved vessel followed by right coronary artery, left circumflex and left main coronary artery. Type IV CAE as per Markis classification was the most common involvement. The median follow-up was 28 ± 20 months, during which 10 patients (19.2%) had recurrent chest pain, and four patients were re-hospitalised, three for unstable angina, one for myocardial infarction.ConclusionThe prevalence of isolated coronary ectasia was 1.05%. The majority of patients had single vessel involvement, and left anterior descending branch was the most common involved vessel. This condition may not be considered completely benign, as it is associated with atherosclerotic risk factors and occurrence of coronary events including angina and myocardial infarction.

Multisystem inflammatory syndrome in children (MIS-C) or paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is an emerging disease in children affected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and thought to be an immune-mediated post-infectious complication of SARS-CoV-2. The disease presentation is similar to Kawasaki disease but has certain distinguishing features. The exact pathogenesis is still not clear but an aberrant immune response, antibody-mediated vascular damage and virus-mediated abnormal type I and III interferon-gamma response are thought to be responsible. Most children who are previously healthy present after 2-4 weeks of SARS-CoV-2 infections with febrile illness of short duration with prominent gastrointestinal, cardiac and hematologic manifestations, progressing to vasoplegic shock, requiring vasopressor therapy. Cardiovascular involvement is prominently marked by acute myocardial injury/myocarditis and the development of coronary artery aneurysms. Laboratory markers of inflammation are elevated uniformly. Most children require intensive care, and few need invasive ventilation. The treatment mainly consists of anti-inflammatory and immunomodulatory therapy like intravenous immunoglobulins and steroids. The overall prognosis is good and reported mortality rates are 0-4%.

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BackgroundPrevious studies have shown that microalbuminuria (MAU) is an independent risk factor for cardiovascular diseases in diabetics, hypertensive patients and in the general population. However, the correlation of MAU with the severity of coronary artery disease (CAD) in non-diabetic patients has not been addressed in detail. This study aimed to investigate the relationship between MAU and severity of angiographically confirmed CAD in non-diabetic patients.MethodsThis was a cross-sectional study, which included 90 non-diabetic patients with documented CAD by coronary angiography. The ratio of urine albumin to creatinine was used to define MAU and severity of CAD was estimated using SYNTAX score. Patients were divided into two groups: group I that included patients without MAU and group II that included patients with MAU.ResultsOut of 90 non-diabetic CAD patients, 62 (68.9%) were in group I (MAU negative) and 28 (31.1%) were in group II (MAU positive). There was statistically significant difference in the median SYNTAX score between the groups (21 vs. 28, P < 0.001). The prevalences of double vessel CAD and triple vessel CAD were significantly higher in MAU positive group. There was a strong relationship between the presence of MAU and the extent and complexity of CAD (r = 0.094; P < 0.001).ConclusionThus, we conclude that patients with MAU have more severe angiographically detected CAD than those without MAU, and MAU exhibits a significant association with the presence and severity of CAD.

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