Coronary Artery Ectasia (CAE) is a well-recognized but relatively uncommon finding encountered during diagnostic coronary angiography in patients who are investigated for ischemic heart disease. There is scarcity of data regarding the behavior of this phenomenon among our local community. Objective: The study was aimed to explore the clinical and angiographic characteristics of patients with CAE in a cohort of Sri Lankan patients. Methods: A retrospective cross-sectional study was conducted at cardiology unit Kandy, Sri Lanka on patients who underwent coronary angiograms from 2014 to 2016. Demographic and clinical data were obtained from medical records. Angiograms were reviewed by two examiners individually. Results: There were 107 patients with CAE with a mean age of 53.51±9.62 years. There were 81.31% (n=87) of males. The prevalence of diabetes, hypertension and dyslipidemia in the study sample was 27.10% (n=29), 28.04% (n=30) and 20.56% (n=22) respectively. Right Coronary Artery (RCA) was the most frequent (60.75%, n=65) culprit territory. Ectasia of the Left Anterior Descending (LAD) artery and Left Circumflex (LCX) were seen in 47.66% (n=51) and 42.99% (n=46) respectively. Severe generalized coronary ectasia [Markis classification type I] was seen in 26.17% (n=28) and type II and III were found in 35.51% (n=38) and 17.76% (n=19) respectively. Localized ectasia was seen in 20.56% (n=22) of cases. There were 38.31% (n=41) having significant atherosclerotic stenosis in the same ectatic arteries and 21.50% (n=23) had stenosis in the non-ectatic arteries (x2 =42.43, p<0.00). These were a higher incidence of Non ST Elevated Myocardial Infarctions (NSTEMI) observed among these patients compared to other acute coronary events. Conclusion: CAE is frequently found in RCA territory and most of the atherosclerotic plaque lesions also were observed in the same ectatic territory. Interestingly, these patients were found to have high preponderance to have recurrent NSTEMIs among all other acute coronary events. Therefore, the micro-vascular mechanisms, endothelial response and intra-vascular flow dynamics of these ectatic patients should be further evaluated to understand the pathophysiology and the behavior of the disease.
