Year: 2026
Type: article
Study design: Case Report
Abstract: BACKGROUND: Coronary artery ectasia (CAE) predisposes to abnormal flow, thrombosis, and adverse cardiovascular outcomes. CASE SUMMARY: A 72-year-old woman with diffuse multivessel CAE, systemic arterial ectasia, and psoriasis presented with inferior ST-segment elevation myocardial infarction in the setting of left bundle branch block. Angiography demonstrated an approximately 8-mm ectatic right coronary artery with complete thrombotic occlusion. Aspiration thrombectomy restored partial flow, but stenting was deferred because of diffuse ectasia, persistent thrombus, and malapposition risk. She was discharged on a direct oral anticoagulant plus single antiplatelet therapy. DISCUSSION: Diffuse CAE is a high-risk thrombotic substrate, and ST-segment elevation myocardial infarction management is challenging because of altered flow, large thrombus burden, and percutaneous coronary intervention limitations. TAKE-HOME MESSAGE: Diffuse systemic ectasia warrants individualized antithrombotic therapy and longitudinal imaging surveillance.
Source: JACC Case Reports
Institution: University of Pennsylvania Health System
Language: English
Topic: Coronary Artery Anomalies
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $850
OpenAlex ID: W7212297229