Overview
Coronary artery atheroma refers to the buildup of plaque within the walls of the coronary arteries, potentially leading to reduced blood flow and cardiovascular complications such as ischemia and infarction. 2 highlights the systemic nature of atheromatous disease, indicating that emboli from aortic plaques can affect distant organs including the retina.Diagnosis
Imaging Techniques: Transesophageal echocardiography can visualize aortic plaques and identify potential sources of emboli in patients with retinal ischemia 2.
Doppler Studies: Transcranial Doppler may detect microembolic signals corroborating embolic events 2.
Exclusion of Other Sources: Cardiac and carotid sources of emboli should be ruled out through comprehensive evaluation 2.Management
Endovascular Approaches: Covered stents may be considered for treating discrete aortic lesions to prevent embolization without destabilizing atheromatous material 1.
Surgical Intervention: Recommended for specific, identifiable offending lesions 1.
No Specific Drug Mentioned: No particular drug classes or doses are highlighted for the management of coronary artery atheroma in the provided abstracts.Special Populations
Elderly: A rare complication involving prolonged catheterization leading to pulmonary atheroma has been noted in elderly patients 3.Key Recommendations
Consider transesophageal echocardiography in patients with retinal ischemia when other sources of emboli are excluded to identify aortic arch atheromas (Evidence: Moderate) 2.
For discrete aortic lesions causing embolization, endovascular treatment with covered stents can be a viable option to prevent further embolization (Evidence: Weak) 1.
In elderly patients, monitor for rare complications such as atheroma formation related to indwelling catheters (Evidence: Expert opinion) 3.References
1 Dougherty MJ, Calligaro KD. Endovascular treatment of embolization of aortic plaque with covered stents. Journal of vascular surgery 2002. link
2 Romano JG, Babikian VL, Wijman CA, Hedges TR. Retinal ischemia in aortic arch atheromatous disease. Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society 1998. link
3 Fievez M, Henuzet CH, Ryckaert MC. Prolonged catheterization. A rare cause of pulmonary atheroma. Chest 1985. link