51
Table 19. Nonatherosclerotic Causes of CCD in Young Adults:
Evaluation and Management
Cause Presentation Management
Kawasaki's
disease
Late sequelae: coronary
artery aneurysm, stenosis,
thrombosis, or fistula
• Lifelong follow-up with
quantitative assessment of luminal
dimensions.
• Low-dose aspirin therapy for
small- or medium-sized coronary
artery aneurysms.
• Low-dose aspirin plus
anticoagulant therapy for large
coronary artery aneurysms.
Coronary artery
anomalies
• Anomalous left
coronary artery from the
pulmonary artery
• Anomalous origin of the
coronary artery from the
opposite sinus of Valsalva
with an interarterial
course
• Surgical repair — translocation of
left coronary artery to aortic root
for anomalous left coronary artery
from the pulmonary artery.
• Surgical correction among young
adults with interarterial course
of coronary artery originating
from opposite sinus of Valsalva
and symptoms during exercise
suggestive of myocardial ischemia.
Myocardial
bridging
• Exercise-induced ischemia
• Coronary artery
vasospasm
• Sudden cardiac death
• Beta-adrenergic blocking agents in
symptomatic patients.
• Restriction to low-intensity sports.
• Surgical correction if symptoms
refractory to medical therapy.
6.4. Cancer
COR LOE
Recommendation
1 C-LD 1. In patients with CCD and cancer, a multidisciplinary team
including cardiolog y and oncolog y expertise is recommended
to improve long-term CVD outcomes.
