Differentiating coronary artery aneurysms due to atherosclerosis or Kawasaki disease / Sherif Rizk Youssef ; Supervised Galal Elsaid , John Gordon , Hala Hamza

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiology

Background: The observed incidence of coronary artery aneurysms (CAAs) varies from 1.5%-4.9%. The two main causes for coronary aneurysms are atherosclerosis and Kawasaki disease (KD). Differentiation between both conditions is important because the prevention, management and prognosis is different. Antecedent KD is frequently missed in developing countries and misdiagnosed as measles, scarlet fever or acute rheumatic fever. Angiographic findings that make antecedent KD the likely cause for the coronary aneurysms from atherosclerosis include proximal location of the aneurysms with or without calcification, associated with angiographically normal distal segments. However, differentiating CAA due to KD versus atherosclerosis can be challenging. So can additional data obtained from IVUS and FFR help to differentiate between both types of aneurysms? Objectives: To test the hypothesis that clinical, demogrphic characteristics, IVUS and FFR can differentiate between KD and atherosclerotic CAAs after being classified according to their angiographic appearance. Methods: To investigate and study CAAs, angiograms and IVUS of 50 patients aged 8 to 60 years of age presenting with symptoms of myocardial ischemia at Cairo University Hospitals and Sharp Memorial Hospital from San Diego were blindly reviewed. Data collected included demographic characteristics, medical history, traditional cardiovascular risk factors, electrocardiographic, angiographic, IVUS and FFR findings

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