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Vol. 17. Núm. 3.
Páginas 130-140 (Mayo - Junio 2010)
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Vol. 17. Núm. 3.
Páginas 130-140 (Mayo - Junio 2010)
DOI: 10.1016/S0120-5633(10)70230-8
Open Access
Aneurisma del tronco principal de la arteria coronaria izquierda Descripción de un caso clínico y revisión de tema
Aneurysm of the main trunk of the left coronary artery Description of a clinical case and kiterature review
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Julio C. Rodríguez1,
Autor para correspondencia
julliusc@yahoo.com.mx

Correspondencia: Fundación Santa Fe de Bogotá. Departamento de Medicina Interna. Calle 119 No. 7-75. Bogotá DC., Colombia. Teléfonos: (571) 603 0303 Fax: (571) 6575714, AA. 220246.
, Alex Rivera1, Bibiana Pinzón1
1 Fundación Santa Fe de Bogotá, Bogotá, Colombia
Este artículo ha recibido
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Under a Creative Commons license
Información del artículo

El aneurisma arterial coronario constituye una entidad rara en la población; su incidencia varía entre 1,5% y 5%, siendo más frecuente en hombres. Existe escasa bibliografía acerca de esta patología a pesar de que su estudio se remonta a finales del siglo XVIII. La arteria que se afecta con mayor frecuencia es la coronaria derecha, aproximadamente en 40% de los casos. La dificultad al momento del diagnóstico clínico radica en que inicialmente el enfoque está dirigido a confirmar y tratar de manera oportuna el síndrome coronario agudo que con insistencia constituye la manifestación inicial con que cursan este tipo de pacientes; por ello el diagnóstico necesariamente requiere ayudas imaginológicas e intervencionistas, o ambas. Hay muchas causas que puedan producir aneurismas en la circulación coronaria, la más común de ellas es la aterosclerosisseguida por trastornos congénitos, enfermedades del tejido conectivo, vasculitis y consumo de cocaína entre otros. Recientemente se han publicado innovadores estudios respecto a la fisiopatología y los avances en terapéutica farmacológica e intervencionista, aunque el tratamiento debe enfocarse en los factores de riesgo, las patologías y las manifestaciones clínicas que presente el paciente.

Palabras clave:
aneurisma arterial coronario
aneurisma sacular
aneurisma fusiforme
ectasia coronaria
isquemia miocárdica
cocaína
enfermedad de Kawasaki
síndrome coronario agudo
arterioesclerosis

Coronary artery aneurysm is a rare entity in the population. Its incidence rates vary between 1.5% - 5%, and is more frequent in males. There is limited literature on this disease, although its study goes back to the late eighteenth century. The most frequently affected artery is the right coronary artery, in approximately 40% of cases. The initial diagnostic difficulty lies in the fact that the initial approach is focused in confirming and treating properly the coronary acute syndrome, which is the most frequent initial presentation in these patients. Therefore, its diagnosis requires necessarily imaging or interventionist aid, or both. Many causes account for coronary aneurysms, being the most common atherosclerosis followed by congenital abnormalities, connective tissue diseases, vasculitis and cocaine consumption. Novel studies regarding the physiopathology and advances in pharmacological and interventionist therapy have been published, although treatment must focus on risk factors, associated pathologies and clinical manifestations.

Key words:
coronary artery aneurysm
sacular aneurysm
fusiform aneurysm
coronary ectasia
myocardial ischemia
cocaine
Kawasaki disease
acute coronary syndrome
atherosclerosis
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