Journal of Vascular Medicine & Surgery

Management of Coronary Arteritis and its Diagnosis, and Treatment Techniques

Feng Xili^* Department of Cardiology, The First People's Hospital of Foshan, Foshan, China
^*Correspondence: Feng Xili, Department of Cardiology, The First People's Hospital of Foshan, Foshan, China, Email:

Received: 27-Mar-2024, Manuscript No. JVMS-24-25609; Editor assigned: 29-Apr-2024, Pre QC No. JVMS-24-25609 (PQ); Reviewed: 12-Apr-2024, QC No. JVMS-24-25609; Revised: 19-Apr-2024, Manuscript No. JVMS-24-25609 (R); Published: 29-Apr-2024, DOI: 10.35248/2329-6925.24.S21.543

Description

Coronary arteritis, a condition characterized by inflammation of the coronary arteries, represents significant challenges in cardiovascular medicine due to its diverse etiology, varied clinical manifestations, and potential for life-threatening complications. Coronary arteritis encompasses a spectrum of inflammatory disorders affecting the coronary arteries, including but not limited to Kawasaki disease, Takayasu arteritis, and giant cell arteritis. While the exact mechanisms underlying coronary arteritis remain insufficiently understood, immune dysregulation, genetic predisposition, and environmental triggers are believed to plays an important role in disease pathogenesis. Inflammation of the coronary arteries can lead to endothelial dysfunction, intimal hyperplasia, and ultimately, luminal narrowing or occlusion, predisposing affected individuals to myocardial ischemia, infarction, and sudden cardiac death.

Kawasaki disease, the most common cause of acquired heart disease in children, manifests as systemic vasculitis affecting medium-sized arteries, including the coronary arteries. Characterized by fever, mucocutaneous changes, lymphadenopathy, and conjunctivitis, Kawasaki disease can lead to coronary artery aneurysms, thrombosis, and myocardial infarction which are not treated. Early recognition and immediate initiation of Intravenous Immunoglobulin (IVIG) therapy are essential for preventing coronary artery complications and reducing the risk of long-term cardiovascular sequelae in affected children.

Takayasu arteritis, a chronic granulomatous vasculitis primarily affecting the aorta and its major branches, can involve the coronary arteries, leading to coronary stenosis, occlusion, or aneurysm formation. Clinical manifestations of Takayasu arteritis vary widely, ranging from nonspecific constitutional symptoms to vascular claudication, pulselessness, and features of myocardial ischemia. Diagnosis depends on a combination of clinical criteria, imaging studies (e.g., magnetic resonance angiography, computed tomography angiography), and invasive angiography to delineate the extent and severity of coronary artery involvement.

Giant cell arteritis, a systemic vasculitis predominantly affecting medium and large arteries, including the aorta and its branches, may usually involve the coronary arteries, leading to myocardial infarction, conduction abnormalities, or sudden cardiac death. Quick identification of giant cell arteritis is essential to prevent devastating complications and mitigate long-term morbidity. Elevation of inflammatory markers such as Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP), along with characteristic clinical features such as headache, jaw claudication, and visual disturbances, aid in establishing the diagnosis.

Treatment techniques for coronary arteritis aim to suppress inflammation, prevent coronary artery complications, and preserve cardiac function. In Kawasaki disease, high-dose aspirin and IVIG are mainstays of therapy, with adjunctive corticosteroids considered in refractory cases or those at high risk for coronary artery aneurysms. In Takayasu arteritis and giant cell arteritis, immunosuppressive agents such as corticosteroids, methotrexate, and biologic agents (e.g., tumor necrosis factor inhibitors) may be employed to achieve disease remission and prevent vascular complications.

Considering the advancements in diagnosis and treatment, coronary arteritis poses ongoing challenges in clinical management, including disease recovery, treatment-related adverse effects, and the need for long-term immunosuppression. Emerging therapeutic modalities, including targeted biologic agents and novel immuno-modulatory therapies, contain potential for improving outcomes and reducing treatment-related toxicity in patients with refractory or recurrent disease. Additionally, continued investigation efforts focus on elucidating the underlying mechanisms of coronary arteritis, identifying biomarkers of disease activity, and developing personalized treatment techniques tailored to individual patient needs.