Yuvraj Singh Chowdhury¹, Rishard Abdul¹, Pramod Theetha Kariyanna¹, Apoorva Jayarangaiah², Mrinali Shetty³, Clara Wilson¹, Naureen Kabani¹, Jonathan D. Marmur¹, Alan Feit¹, Moro O. Salifu¹, Isabel M. McFarlane^1,

Coronary artery ectasia (CAE) is defined by the Coronary Artery Surgery Study (CASS) registry as the aneurysmal dilatation 1.5 times the diameter of a coronary artery compared to the adjacent normal coronary artery. CAE is reported with a prevalence of 1.2% - 4.9%. Most CAEs are attributed to atherosclerosis or post-percutaneous coronary intervention (PCI) vessel injury. Vasculitides and infection are uncommon etiologies. A review of 59,423 patients from the Danish registry demonstrated a 3-fold increase in the prevalence of abdominal aortic aneurysms in patients with concomitant severe psoriasis. We present a case of a 64-year-old male with severe plaque psoriasis complaining of substernal chest pain whose coronary angiography demonstrated CAE of the left anterior descending and circumflex arteries. Due to its pro-inflammatory state, psoriasis is associated with various systemic manifestations including cardiac and vascular complications. With possibly a similar underlying pathophysiological mechanism, we describe to the best of our knowledge the first case of CAE in a patient with severe psoriasis.

coronary artery ectasia, psoriasis, inflammation, atherosclerosis, abdominal anerurysms