Originala Articles Korean Circulation J 2000;30 10 : 관상동맥확장증의임상및관상동맥조영술상특성 김원 1 정명호 2 김계훈 1 김건형 1 이승욱 1 김남호 1 안영근 1 조정관 2 박종춘 2 강정채 2 Clinica

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1 Originala Articles Korean Circulation J 2000;3010: 관상동맥확장증의임상및관상동맥조영술상특성 김원 1 정명호 2 김계훈 1 김건형 1 이승욱 1 김남호 1 안영근 1 조정관 2 박종춘 2 강정채 2 Clinical and Angiographic Characteristics of Coronary Artery Ectasia Weon Kim, MD 1, Myung Ho Jeong, MD 2, Kye Hun Kim, MD 1, Kun Hyung Kim, MD 1, Seung Wook Lee, MD 1, Nam Ho Kim, MD 1, Young Keun Ahn, MD 1, Jeong Gwan Cho, MD 2, Jong Chun Park, MD 2 and Jung Chaee Kang, MD 2 1 The Heart Center, Chonnam National University Hospital, Kwangju, 2 The Research Institute of Medical Sciences, Chonnam National University, Kwangju, Korea ABSTRACT BackgroundCoronary artery ectasia is an abnormal enlargement of coronary artery and infrequently associated with acute coronary syndrome. The prognosis, treatment, and etiology of this disease remain unclear. Method Sixtyone patients 35 male and 26 female, years out of 4,694 patients who underwent diagnostic coronary angiography at Chonnam National University Hospital between January 1996 and March 1999, and diagnosed as isolated coronary artery dilatatation without significant stenosis, were analyzed retrospectively. ResultsThe incidence of coronary artery ectasia on the coronary angiography was 1.29%. Smoking was the most frequently associated risk factor. Clinical diagnosis was % cases of stable angina, % unstable angina, % acute myocardial infarction, 5 8.1% old myocardial infarction, and 2 3.3% variant angina. Right coronary artery was the most frequent involved artery 42.5%. Type according to Markins classification was 63.9%. Proximal part of coronary artery was the most common involved arterial segment. Aspirin 78.7%, calcium antagonist 73.8%, nitrate 29.5% and -blocker 12% were used. During clinical follow-up of months, there were no major cardiac event in all patients. ConclusionThe incidence of the coronary artery ectasia in Korean patients was relatively rare, and long-term prognosis was good. Korean Circulation J 2000; 30 10: KEY WORDSCoronary ectasia Coronary angiograpy Prognosis. 서 론 1205

2 대상및방법 관찰대상 관상동맥확장증의정의및분류 방법 Fig. 1. Markis classfication for coronary artery ectasia. Reprinted Sorrell VL et al. Current knowledge and significance of coronary artery ectasia. Clin Cardiol Korean Circulation J 2000;3010:

통계 결과 관상동맥확장증의유병률 대상환자의임상적특징 Table 2. Clinical characteristics of the patients No % Fig. 2. A patient presented with acute inferior myocardial infarction.

No significant change demonstrated on 6-month follow-up coronary angiography. Table 1.

3 통계 결과 관상동맥확장증의유병률 대상환자의임상적특징 Table 2. Clinical characteristics of the patients No % Fig. 2. A patient presented with acute inferior myocardial infarction. Coronary angiography revealed diffuse coronary ectasia type I according to Markis classification with intracoronary thrombus in the distal right coronary artery white arrow. No significant change demonstrated on 6-month follow-up coronary angiography. Table 1. Classification of coronary artery ectasia Diffuse ectasia involving two or more vessel Diffuse ectasia involving one vessel and localized ectasia involving another Diffuse ectasia involving one vessel only Localized or segmental ectasia only Age years Sex Male Female Clinical diagnosis Stable angina Unstable angina Acute myocardial infarction Old myocardial infarction Variant angina Risk factors Smoking Hypertension Hypercholesterolemia Diabetes mellitus Family history Hypertension Ischemic heart disease

4 관상동맥조영술소견 약물치료 추적관찰 1208 Table 3. Angiographic characteristics of the patients Markis classification 고 안 No % Type Type Type Type Involved artery n120 Left anterior descending artery Left circumflex artery Right coronary artery Table 4. Results of medical treatment and clinical follow-up Medical treatment Number % Aspirin Calcium antagonist Nitrate Angiotension converting enzayme inhibitor Beta-blocker Anti-platelet agent Clinical follow-up Asymptomatic Angina pectoris Atypical chest pain Acute myocardial infarction Cardiac death Korean Circulation J 2000;3010:

5 1209

6 1210 Korean Circulation J 2000;3010:

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노영남

노영남 Purpose: Delayed massive hemorrhages from pseudoaneurysm rupture of the peripancreatic large arteries, after pancreaticoduodenectomy, are fatal. We reviewed the clinical course and outcome of bleeding