What Is a Coronary Artery Aneurysm?

A coronary artery aneurysm is a structural abnormality of the coronary arteries. With this deformity, the wall of the artery pouches out, causing the affected artery to have an increased diameter. Symptoms of the condition could include chest pain, and complications could include heart attack. The condition can develop due to genetic abnormalities, acquired conditions, or from manipulation of the blood vessel walls. Those with this condition may be treated with medications or surgery.

Symptoms of a coronary artery aneurysm can vary. Some patients might not have any symptoms, and might only learn that they have this condition when they undergo testing for other purposes. Other patients could have chest pain, chest pressure, or irregular heartbeats. Having this blood vessel abnormality could even lead to a heart attack, otherwise known as a myocardial infarction. Other complications might include rupture of the wall of the artery and development of blood clots in the out-pouching of the blood vessel wall, which could lead to serious consequences.

Patients might develop a coronary artery aneurysm for a number of reasons. A childhood autoimmune disorder called Kawasaki disease is the classic cause, and children affected by it are monitored for the development of this condition for many years after the acute illness resolves. Some patients might have congenital weaknesses in the walls of their blood vessels, putting them at increased risk for developing a coronary artery aneurysm. Additional causes of the condition can include atherosclerosis, systemic lupus erythematosus, syphilis, and cancer. Sometimes the aneurysms can develop as a result of procedures done on the coronary arteries, including angioplasty and laser treatments.

Diagnosis of a coronary artery aneurysm is typically made on the basis of imaging studies. Computed tomography (CT) or magnetic resonance imaging (MRI) scans focusing on elucidating the flow of blood around the heart could suggest the diagnosis. Often the diagnosis is confirmed by performing a procedure called a coronary artery catheterization, in which a small wire is advanced into the arteries of the heart, allowing doctors to visualize the arteries directly.

Treatment of a coronary artery aneurysm can be controversial. Some doctors recommend that patients should manage the condition by taking medications that will optimize the function of the heart and minimize the risk for developing plaques in the walls of the coronary arteries. Often these patients are also started on medications that thin the blood with the goal of preventing the development of blood clots in these blood vessel abnormalities. Other physicians may recommend surgical interventions to fix the walls of the arteries.