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Review
. 2021 Jan 6;21(1):7.
doi: 10.1186/s12872-020-01813-6.

Coronary artery vasculitis: a review of current literature

Shaun Khanna  1 , Kartheek Garikapati  2 , Daniel S L Goh  2 , Kenneth Cho  2 , Phillip Lo  2 , Mohan V Bhojaraja  3 , Surjit Tarafdar  2   4
Affiliations
Review

Coronary artery vasculitis: a review of current literature

Shaun Khanna et al. BMC Cardiovasc Disord. .

Abstract

Cardiac vasculitis is recognized as a heterogeneous disease process with a wide spectrum of manifestations including pericarditis, myocarditis, valvular heart disease and less frequently, coronary artery vasculitis (CAV). CAV encompasses an emerging field of diseases which differ from conventional atherosclerotic disease and have a proclivity for the younger population groups. CAV portends multiple complications including the development of coronary artery aneurysms, coronary stenotic lesions, and thrombosis, all which may result in acute coronary syndromes. There are several aetiologies for CAV; with Kawasaki's disease, Takayasu's arteritis, Polyarteritis Nodosa, and Giant-Cell Arteritis more frequently described clinically, and in literature. There is a growing role for multi-modality imaging in assisting the diagnostic process; including transthoracic echocardiography, cardiac magnetic resonance imaging, computed tomography coronary angiography, fluorodeoxyglucose-positron emission tomography and conventional coronary angiogram with intravascular ultrasound. Whilst the treatment paradigms fundamentally vary between different aetiologies, there are overlaps with pharmacological regimes in immunosuppressive agents and anti-platelet therapies. Interventional and surgical management are is a consideration in select populations groups, within a multi-disciplinary context. Further large-scale studies are required to better appropriately outline management protocols in this niche population.

Keywords: Coronary artery vasculitis; Giant cell arteritis; Kawasaki’s disease; Polyarteritis nodosa; Takayasu’s arteritis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Echocardiogram shows a 30 mm wide hypoechoic structure lateral to the right atrium (arrow) (a). The structure is diagnosed as 30 × 40 mm right coronary aneurysm (arrow) using coronary angiography (b). (Adapted with permission from Ebersberger U, Rieber J, Wellmann P, Goebel C, Gansera B. Polyarteritis nodosa causing a vast coronary artery aneurysm. J Am Coll Cardiol. 2015 10;65(5):e1–2. https://doi.org/10.1016/j.jacc.2013.08.1667. PMID: 25660937) Copyright [2013] by Ullrich Ebersberger, JACC
Fig. 2
Fig. 2
Central illustration: treatment of coronary artery vasculitis. IVIG, Intravenous Immunoglobulin; CAV, Coronary Artery Vasculitis
See this image and copyright information in PMC

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