151 International Journal of Scientifc Study | November 2015 | Vol 3 | Issue 8 Analysis of Coronary Artery Ectasia: Experience from a Tertiary Care Hospital in South India S Sadhanandham 1 , Dinesh David 2 , T R Muralidharan 3 , K Vengadakrishnan 4 1 Assistant Professor, Department of Cardiology, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India, 2 Resident, Department of Cardiology, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India, 3 Professor, Department of Cardiology, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India, 4 Professor, Department of General Medicine, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India normal coronary artery. CAE can be found in up to 5% of angiographic and in 0.22% to 1.4% of autopsy series. It can be either diffuse affecting the entire length of a coronary artery or localized. When the dilatation involves the entire vessel, the word “ectasia” is used instead of an aneurysm. CAE or the aneurysm is attributed to atherosclerosis in 50% of cases, whereas 20-30% have been considered to be congenital in origin. In the great majority of these patients, ectasia coexists with CAD. Only 10-20% of cases of CAE have been described in association with infammatory or connective tissue diseases. In the western population, the most common association had been with coronary atherosclerosis. Other conditions in which CAE or an aneurysm has been noted include Ehlers Danlos syndrome, polyarteritis nodosa, scleroderma, cystic medionecrosis, trauma, mycotic embolus, syphilitic aortitis, antineutrophil cytoplasmic antibody-related vasculitis, Kawasaki disease, and iatrogenic (angioplasty and atherectomy). 2-6 INTRODUCTION Coronary artery ectasia (CAE) has been recognized as an uncommon pathological fnding for many years. The frst autopsy-proven demonstration of CAE was done by Morgagni 1 in 1761 and Gougon in 1812. It affects 0.46-4% of general population, but the etiology of the disorder remains uncertain. CAE or aneurysmal coronary artery disease (CAD) is defned as dilatation of an arterial segment to a diameter of at least 1.5 times that of the adjacent Original Article Abstract 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 fow, 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 modifed Bruce protocol. The angiogram flms 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 circumfex 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 fow limiting obstructive lesions and could have guarded prognosis in view of its propensity of layered thrombus formation. Key words: Coronary angiogram, Coronary artery disease, Coronary ectasia, Right coronary artery Access this article online www.ijss-sn.com Month of Submission : 09-2015 Month of Peer Review : 10-2015 Month of Acceptance : 11-2015 Month of Publishing : 11-2015 Corresponding Author: Dr. K Vengadakrishnan, Department of General Medicine, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India. Phone: +91-9840131997. E-mail: drkvk1975@gmail.com DOI: 10.17354/ijss/2015/529