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Review
. 2021 May 31;9(6):622.
doi: 10.3390/biomedicines9060622.

Coronary Vasculitis

Tommaso Gori  1
Affiliations
Review

Coronary Vasculitis

Tommaso Gori. Biomedicines. .

Abstract

The term coronary "artery vasculitis" is used for a diverse group of diseases with a wide spectrum of manifestations and severity. Clinical manifestations may include pericarditis or myocarditis due to involvement of the coronary microvasculature, stenosis, aneurysm, or spontaneous dissection of large coronaries, or vascular thrombosis. As compared to common atherosclerosis, patients with coronary artery vasculitis are younger and often have a more rapid disease progression. Several clinical entities have been associated with coronary artery vasculitis, including Kawasaki's disease, Takayasu's arteritis, polyarteritis nodosa, ANCA-associated vasculitis, giant-cell arteritis, and more recently a Kawasaki-like syndrome associated with SARS-COV-2 infection. This review will provide a short description of these conditions, their diagnosis and therapy for use by the practicing cardiologist.

Keywords: coronary artery disease; inflammatory diseases; vasculitis.

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Conflict of interest statement

The author declares no conflict of interest.

Figures

Figure 1
Figure 1
Coronary angiography (A–C) and computed tomography image (D) of three-vessel disease in a 22-years old patient with polyarteritis nodosa. Angiography showed chronic total occlusion of the right and circumflex coronaries. Reproduced with permission from [26] under the creative common license (http://creativecommons.org/publicdomain/zero/1.0/) (accessed on 3 March 2021).
Figure 2
Figure 2
Coronary aneurysms in an 80-year-old female patient with stroke and rheumatoid arthritis. Panel a: right coronary; Panel b: left coronary (arrows mark the aneurysms). The patient had been admitted for sudden loss of consciousness. Chest computed tomography (panels A–C, Video S1) was performed for the suspect of lung embolism. The exam showed severe coronary aneurysms. At angiography (panel D,E), the aneurysms were so large that they could not be imaged in one single run despite large contrast volume.
Figure 3
Figure 3
Spontaneous dissection (arrows) in a 45-years old woman causing non-ST elevation myocardial infarction.
Figure 4
Figure 4
Coronary spasm in a 51-year-old female patient with ANCA-associated vasculitis and spasm of the proximal left anterior descending (panel a) causing a Tako-Tsubo-like contractile dysfunction (b,c).
See this image and copyright information in PMC

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