Document Detail


Coronary artery aneurysm: a review and hypothesis regarding etiology.
MedLine Citation:
PMID:  18466032     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Coronary artery aneurysm is an uncommon condition that can be a cause of death when it thromboses or ruptures. It is always associated with destruction of the tunica media, usually associated with atherosclerosis, and commonly associated with chronic inflammation. OBJECTIVE: To review the pathology, epidemiologic and clinical features, and pathophysiology of coronary artery aneurysm, particularly new research results, drawing out implications for the understanding, diagnosis, and treatment of this condition. DATA SOURCES: Pertinent literature and illustrative cases at our institution. CONCLUSIONS: Inflammation spilling over into the tunica media from the tunica intima may link atherosclerosis to aneurysm formation, but vasculitis without atherosclerosis causes coronary artery aneurysms in young children with Kawasaki disease. Increased proteolysis of extracellular matrix proteins is probably one mechanism of coronary artery aneurysm formation, either due to overactive matrix metalloproteinases or underactive inhibition of these proteinases, and an excess of transforming growth factor beta may be another mechanism in the pathogenesis. Coronary atherosclerosis is a universal disease of adults, but only 1.5% of them have coronary aneurysms; this small group may be those with a second coronary artery disease, such as vasculitis.
Authors:
Larry Nichols; Stephen Lagana; Anil Parwani
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Archives of pathology & laboratory medicine     Volume:  132     ISSN:  1543-2165     ISO Abbreviation:  Arch. Pathol. Lab. Med.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-09     Completed Date:  2008-05-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7607091     Medline TA:  Arch Pathol Lab Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  823-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Pathology, University of Pittsburgh Medical Center, A610 Scaife Hall, 200 Lothrop St, Pittsburgh, PA 15213-2582, USA. nicholsla@upmc.edu
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MeSH Terms
Descriptor/Qualifier:
Arteriosclerosis / complications
Coronary Aneurysm / etiology*,  therapy
Coronary Vessels / pathology*
Genetic Predisposition to Disease
Germany / epidemiology
Humans
United States / epidemiology

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