Coronary artery ectasia is an infrequent finding seen in a localized or diffuse fashion in patients undergoing coronary angiogram. This angiographic entity is attributed to coronary artery atherosclerosis. The ectatic coronary artery segment may be a culprit and perpetuate the thrombus formation in patients with acute myocardial infarction due to the altered normal laminar flow and deranged platelet and endothelial activation. Besides, it may lead to slow flow/no-reflow during the percutaneous coronary intervention and constitutes a significant management challenge. In this article, we report three patients with ST-segment elevation myocardial infarction from the culprit ectatic infarct-related artery and discuss the various management strategies.
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