Imaging of acquired coronary diseases: From children to adults

Abstract

Acquired coronary diseases include aneurysms, fistulae, dissections, and stenosis. Aneurysms may occur secondarily to Kawasaki disease, a childhood vasculitis, the prognosis of which depends on the coronary involvement, or they may be degenerative, infectious, inflammatory, or traumatic in origin. Fistulae develop between the coronary arterial system and a pulmonary or bronchial artery, or cardiac cavity. Dissections may occur spontaneously or may be post-traumatic. These coronary abnormalities may be found incidentally or may present as complications, infarction or rupture. The goals of this article are to understand acquired childhood and adult coronary diseases and their usual means of presentation, the ways of investigating them, and the principles of their treatment.

CT coronary angiography findings in non-atherosclerotic coronary artery diseases

“…Coronary artery aneurysm (CAA) is defined as the dilatation of coronary arteries which exceeds the diameter of adjacent normal artery segments or the diameter of the largest coronary artery by 1.5 times. Aneurysms can be classified into true aneurysms (affecting the three arterial linings)and false aneurysms 152 (the arterial wall is damaged, often as a result of injury or iatrogenic cause) 19 .…”

“…The LAD, main stem, more rarely the LCx, and the distal coronary segments 19 . The 166 systemic vasculitis results in formation of CAA 23 .…”

“…The reported incidence of SCAD was between 0.1% and 0.28% in angiographic population 25 . The LAD is most commonly affected, followed by the RCA 19 . The disease has been broadly classified into atherosclerotic and non-atherosclerotic in origin.…”

An Unexpected Finding in a Diabetic Patient Studied With Transthoracic Echocardiography

“…They are usually congenital, but acquired forms do occur especially in the patient to adulthood. 1,2 Their clinical importance usually in the adulthood is due to an increased risk of complications, including heart failure, myocardial ischemia, infective endocarditis, arrhythmias, and rupture . The acquired causes of coronary fistulas include coronary atherosclerosis (our patient, with diabetes, was marked by a multi district atherosclerotic disease and also coronary atherosclerotic damage, and his history showed the patient was already suffering from AMI), Takayasu arteritis, and trauma.…”

Clinical Applications of Late Gadolinium in Children

“…Myocardial infarction can develop in the setting of large coronary aneurysms. CMR with LGE sequence is a valuable non-invasive method for simultaneous evaluation of coronary arteries anatomy, cardiac function, myocardial inflammation in the acute phase and fibrosis in the chronic follow-up [2,11,16,17].…”