Genetic testing in patients with unexplained coronary aneurysms or dilation

Coronary artery dilatation (defined in CAAR – Coronary Artery Aneurysm Registry - as a diameter exceeding 1.5x an adjacent normal coronary segment or the largest normal artery) is evident in at least 0.35% of all diagnostic coronary angiograms. 1 Coronary aneurysms arediscrete dilated segments bounded by normal coronary segments. Coronary dilation may also be more diffuse, often involving the proximal and mid vessel with a normal calibre distal vessel. In contrast to arterial dilation in other vascular beds, coronary dilation is not usually progressive and rupture appears very rare (1/1565 recorded in CAAR survivors over 37.2 months follow-up). 1 The main clinical sequelae is coronary thrombosis leading to acute myocardial infarction. Patients followed up after an angiographic finding of coronary dilation have high major adverse cardiovascular event rates (31% at 37.2 months). [Opening paragraph]