Non-atherosclerotic coronary artery disease
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- updated 26 Nov 2022:
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Non-atherosclerotic coronary artery disease or nonatheroscleroticnon-atherosclerotic coronary artery abnormalities are a heterogeneous group of abnormalities that can cause myocardial ischaemia or sudden cardiac death with the exclusion of coronary artery disease 1-3.
Epidemiology
Due to the diversity non-atherosclerotic coronary disease is found in all age groups and it is frequently described in younger male individuals and in women 1-3.
Associations
NonThe non-atherosclerotic coronary disease can be associated with the following 1-5:
Diagnosis
The diagnosis of non-atherosclerotic coronary disease can be established on imaging most commonly either cardiac CT or invasive coronary angiography with or without intravascular imaging such as intravascular ultrasound (IVUS) or optical coherence tomography (OCT). Due to the association with sudden cardiac death, the diagnosis is also made on postmortem examinations 1,2.
Pathology
Aetiology
Causes of nonatherosclerotic of coronary artery diseases or abnormalities include the following pathologies 1-9:
-
congenital coronary artery anomalies
coronarycoronary hypoplasiacoronary artery fistulamyocardial bridging
-
coronary embolism
endocarditisendocarditisatrialintracardiac thrombi
coronary artery aneurysm (including mycotic aneurysms and pseudoaneurysms)
-
spontaneousspontaneous coronary artery dissection 3 (e.g. in peripartum women or Marfan’s syndrome)aorticaortic dissection (Stanford A) involving coronary arteriesiatrogeniciatrogenic or traumatic coronary artery dissection
-
coronary arteritis
TakayasuTakayasu arteritis 3,6BehcetBehcet disease 6KawasakiKawasaki diseasepolyarteritispolyarteritis nodosasyphiliticsyphilitic aortitis
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myocardial bridgingfibromuscular dysplasia 3,ref
idiopathic arterial calcification of infancy
-<p>Non-atherosclerotic coronary artery disease or nonatherosclerotic coronary artery abnormalities are a heterogeneous group of abnormalities that can cause myocardial ischaemia or sudden cardiac death with the exclusion of coronary artery disease <sup>1-3</sup>.</p><p></p><h4>Epidemiology</h4><p>Due to the diversity non-atherosclerotic coronary disease is found in all age groups and it is frequently described in younger male individuals and in women <sup>1-3</sup>.</p><h5>Associations</h5><p>Non-atherosclerotic coronary disease can be associated with the following <sup>1-5</sup>:</p><p>myocardial ischaemia (acute and chronic coronary syndromes)</p><p>myocardial infarction</p><p>cardiac arrest</p><p>sudden cardiac death</p><h4>Diagnosis</h4><p>The diagnosis of non-atherosclerotic coronary disease can be established on imaging most commonly either cardiac CT or invasive coronary angiography with or without intravascular imaging such as intravascular ultrasound or optical coherence tomography. Due to the association with sudden cardiac death the diagnosis is also made on postmortem examinations <sup>1,2</sup>.</p><h4>Pathology</h4><h5>Aetiology</h5><p>Causes of nonatherosclerotic of coronary artery diseases or abnormalities include the following pathologies <sup>1-9</sup>:</p><p></p><p>congenital coronary artery anomalies</p><p> anomalous origin of coronary arteries</p><p> anomalous course of coronary arteries</p><p> coronary hypoplasia</p><p> coronary arteriovenous malformations</p><p>coronary artery fistula</p><p>coronary embolism</p><p> endocarditis</p><p> atrial thrombi</p><p>coronary artery aneurysm (including mycotic aneurysms and pseudoaneurysms)</p><p>coronary dissection</p><p> spontaneous coronary artery dissection <sup>3</sup> (e.g. in peripartum women or Marfan’s syndrome)</p><p> aortic dissection (Stanford A) involving coronary arteries</p><p> iatrogenic or traumatic coronary artery dissection</p><p>coronary vasospasm</p><p>coronary arteritis</p><p> Takayasu arteritis <sup>3,6</sup></p><p> Behcet disease <sup>6</sup></p><p> Kawasaki disease</p><p> polyarteritis nodosa</p><p> IgG4-related coronary disease</p><p> syphilitic aortitis</p><p>myocardial bridging</p><p>fibromuscular dysplasia <sup>3,ref</sup></p><p>idiopathic arterial calcification of infancy</p>- +<p><strong>Non-atherosclerotic coronary artery disease</strong> or <strong>non-atherosclerotic coronary artery abnormalities</strong> are a heterogeneous group of abnormalities that can cause <a href="/articles/myocardial-ischaemia" title="myocardial ischaemia">myocardial ischaemia</a> or <a href="/articles/sudden-cardiac-death" title="sudden cardiac death">sudden cardiac death</a> with the exclusion of <a href="/articles/coronary-artery-disease" title="Coronary artery disease">coronary artery disease</a> <sup>1-3</sup>.</p><h4>Epidemiology</h4><p>Due to the diversity non-atherosclerotic coronary disease is found in all age groups and it is frequently described in younger male individuals and women <sup>1-3</sup>.</p><h5>Associations</h5><p>The non-atherosclerotic coronary disease can be associated with the following <sup>1-5</sup>:</p><ul>
- +<li><p><a href="/articles/myocardial-ischaemia" title="Myocardial ischaemia">myocardial ischaemia</a> (<a href="/articles/acute-coronary-syndrome" title="Acute coronary syndrome">acute</a> and <a href="/articles/chronic-coronary-syndrome" title="Chronic coronary syndromes">chronic coronary syndromes</a>)</p></li>
- +<li><p><a href="/articles/myocardial-infarction" title="Myocardial infarction">myocardial infarction</a></p></li>
- +<li><p><a href="/articles/cardiac-arrest" title="Cardiac arrest">cardiac arrest</a></p></li>
- +<li><p><a href="/articles/sudden-cardiac-death" title="Sudden cardiac death">sudden cardiac death</a></p></li>
- +</ul><h4>Diagnosis</h4><p>The diagnosis of non-atherosclerotic coronary disease can be established on imaging most commonly either <a href="/articles/cardiac-ct-1" title="Cardiac CT">cardiac CT</a> or invasive coronary angiography with or without intravascular imaging such as intravascular ultrasound (IVUS) or optical coherence tomography (OCT). Due to the association with sudden cardiac death, the diagnosis is also made on postmortem examinations <sup>1,2</sup>.</p><h4>Pathology</h4><h5>Aetiology</h5><p>Causes of nonatherosclerotic coronary artery diseases or abnormalities include the following pathologies <sup>1-9</sup>:</p><ul>
- +<li>
- +<p><a href="/articles/congenital-coronary-artery-anomalies" title="Congenital coronary artery anomalies">congenital coronary artery anomalies</a></p>
- +<ul>
- +<li><p><a href="/articles/anomalous-aortic-origin-of-coronary-artery" title="Anomalous aortic origin of coronary artery">anomalous origin of coronary arteries</a></p></li>
- +<li><p><a href="/articles/anomalous-course-of-coronary-arteries" title="Anomalous course of coronary arteries">anomalous course of coronary arteries</a></p></li>
- +<li><p><a href="/articles/coronary-hypoplasia" title="Coronary hypoplasia">coronary hypoplasia</a></p></li>
- +<li><p><a href="/articles/coronary-arteriovenous-fistula" title="Coronary arteriovenous fistula">coronary arteriovenous fistula</a></p></li>
- +<li><p><a href="/articles/myocardial-bridging-of-the-coronary-arteries" title="Myocardial bridging of the coronary arteries">myocardial bridging</a></p></li>
- +</ul>
- +</li>
- +<li>
- +<p>coronary embolism</p>
- +<ul>
- +<li><p><a href="/articles/infective-endocarditis" title="Infective endocarditis">endocarditis</a></p></li>
- +<li><p><a href="/articles/intracardiac-thrombus-1" title="Intracardiac thrombus">intracardiac thrombi</a></p></li>
- +</ul>
- +</li>
- +<li><p><a href="/articles/coronary-artery-aneurysm" title="Coronary artery aneurysm">coronary artery aneurysm</a> (including mycotic aneurysms and pseudoaneurysms)</p></li>
- +<li>
- +<p><a href="/articles/coronary-artery-dissection" title="Coronary artery dissection">coronary artery dissection</a></p>
- +<ul>
- +<li><p>spontaneous coronary artery dissection <sup>3</sup> (e.g. in peripartum women or Marfan’s syndrome)</p></li>
- +<li><p><a href="/articles/aortic-dissection" title="Aortic dissection">aortic dissection</a> (Stanford A) involving coronary arteries</p></li>
- +<li><p>iatrogenic or traumatic coronary artery dissection</p></li>
- +</ul>
- +</li>
- +<li><p><a href="/articles/vasospastic-angina" title="Coronary vasospasm">coronary vasospasm</a></p></li>
- +<li>
- +<p>coronary arteritis</p>
- +<ul>
- +<li><p><a href="/articles/takayasu-arteritis" title="Takayasu arteritis">Takayasu arteritis</a> <sup>3,6</sup></p></li>
- +<li><p><a href="/articles/behcet-disease-2" title="Behcet disease">Behcet disease</a> <sup>6</sup></p></li>
- +<li><p><a href="/articles/kawasaki-disease" title="Kawasaki disease">Kawasaki disease</a></p></li>
- +<li><p><a href="/articles/polyarteritis-nodosa-1" title="Polyarteritis nodosa">polyarteritis nodosa</a></p></li>
- +<li><p><a href="/articles/igg4-related-coronary-disease-2" title="IgG4-related coronary disease">IgG4-related coronary disease</a></p></li>
- +<li><p><a href="/articles/syphilitic-aortitis" title="Syphilitic aortitis">syphilitic aortitis</a></p></li>
- +</ul>
- +</li>
- +<li><p><a href="/articles/fibromuscular-dysplasia-1" title="Fibromuscular dysplasia">fibromuscular dysplasia</a> <sup>3,ref</sup></p></li>
- +<li><p>idiopathic arterial calcification of infancy</p></li>
- +</ul>
References changed:
- 1. Hill S & Sheppard M. Non-Atherosclerotic Coronary Artery Disease Associated with Sudden Cardiac Death. Heart. 2010;96(14):1119-25. <a href="https://doi.org/10.1136/hrt.2009.185157">doi:10.1136/hrt.2009.185157</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/20511306">Pubmed</a>
- 2. Corrado D, Thiene G, Cocco P, Frescura C. Non-Atherosclerotic Coronary Artery Disease and Sudden Death in the Young. Br Heart J. 1992;68(6):601-7. <a href="https://doi.org/10.1136/hrt.68.12.601">doi:10.1136/hrt.68.12.601</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/1467055">Pubmed</a>
- 3. Jinnouchi H, Finn A, Virmani R. Nonatherosclerotic Vascular Disease in Women. Tex Heart Inst J. 2018;45(4):233-5. <a href="https://doi.org/10.14503/THIJ-18-6675">doi:10.14503/THIJ-18-6675</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30374233">Pubmed</a>
- 4. Kosmas N, Manolis A, Dagres N, Iliodromitis E. Myocardial Infarction or Acute Coronary Syndrome with Non-Obstructive Coronary Arteries and Sudden Cardiac Death: A Missing Connection. EP Europace. 2020;22(9):1303-10. <a href="https://doi.org/10.1093/europace/euaa156">doi:10.1093/europace/euaa156</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/32894280">Pubmed</a>
- 5. Chandra S, Singh V, Nehra M, Agarwal D, Singh N. ST-Segment Elevation in Non-Atherosclerotic Coronaries: A Brief Overview. Intern Emerg Med. 2011;6(2):129-39. <a href="https://doi.org/10.1007/s11739-010-0491-5">doi:10.1007/s11739-010-0491-5</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/21153605">Pubmed</a>
- 6. Zhou Z, Xu L, Zhang N et al. CT Coronary Angiography Findings in Non-Atherosclerotic Coronary Artery Diseases. Clin Radiol. 2018;73(2):205-13. <a href="https://doi.org/10.1016/j.crad.2017.07.007">doi:10.1016/j.crad.2017.07.007</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/28797768">Pubmed</a>
- 7. Cury R, Blankstein R, Leipsic J et al. CAD-RADS™ 2.0 - 2022 Coronary Artery Disease - Reporting and Data System an Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the American College of Radiology (ACR) and the North America Society of Cardiovascular Imaging (NASCI). J Cardiovasc Comput Tomogr. 2022. <a href="https://doi.org/10.1016/j.jcct.2022.07.002">doi:10.1016/j.jcct.2022.07.002</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/35864070">Pubmed</a>
- 8. Persu A, Dobrowolski P, Gornik H et al. Current Progress in Clinical, Molecular, and Genetic Aspects of Adult Fibromuscular Dysplasia. Cardiovasc Res. 2022;118(1):65-83. <a href="https://doi.org/10.1093/cvr/cvab086">doi:10.1093/cvr/cvab086</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/33739371">Pubmed</a>
- 9. Neves D, Bento Â, Fernandes R, Patrício L, Aguiar J. Spontaneous Coronary Artery Dissection: Still a Lot to Learn. Rev Port Cardiol. 2017;36(1):59.e1-5. <a href="https://doi.org/10.1016/j.repc.2016.06.012">doi:10.1016/j.repc.2016.06.012</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27988230">Pubmed</a>
Tags changed:
- coronary artery
- heart disease
Systems changed:
- Cardiac
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