Prefer primary PCI over thrombolysis for STEMI with known CAA
Patient Discharge Instructions
copy discharge instructions
Diagnosis and medication understanding
You have been diagnosed with a coronary artery aneurysm (CAA)
This is a widening or ballooning of one of the arteries supplying your heart
It can increase your risk of blood clots forming inside the artery
Take all prescribed blood-thinning medications exactly as directed
Do not stop aspirin, clopidogrel, or warfarin without calling your cardiologist
Missing doses can cause a dangerous blood clot to form in the artery
If taking warfarin, attend all INR blood test appointments
Your target INR is between 2.0 and 3.0
Report any unusual bruising, black stools, or blood in urine immediately
Activity and lifestyle
Heart-healthy diet
Mediterranean-style diet low in saturated fat
Consistent vitamin K intake if on warfarin (avoid large changes in leafy greens)
Strict avoidance of cocaine and all stimulants
These drugs directly damage coronary arteries and can cause aneurysm rupture
Inform your physician of any substance use without fear of judgment
Activity guidance
Discuss return to exercise with your cardiologist before resuming vigorous activity
Avoid contact sports or high-injury activities if on dual antiplatelet or anticoagulation
Adequate hydration
Reduces risk of blood clot formation, especially with large aneurysms
Drink at least 6–8 glasses of water daily
Follow-up and monitoring
Cardiology appointment within 1–2 weeks
Bring a list of all current medications to each visit
Imaging surveillance plan will be discussed
INR or blood test monitoring as directed
Regular monitoring is essential for safety on blood thinners
Notify your cardiologist of any new medications prescribed by other doctors
Return to emergency department immediately for
Chest pain, pressure, or tightness (new or worsening)
Even if it seems mild — do not drive yourself
Call emergency services
Shortness of breath at rest or with minimal exertion
Sudden onset is particularly concerning
May indicate a blood clot or heart failure
Syncope or fainting episode
Or near-fainting (pre-syncope, dizziness, lightheadedness)
May indicate dangerous heart rhythm or low cardiac output
Palpitations with dizziness or chest discomfort
Could indicate a dangerous heart rhythm
ECG required urgently
Signs of bleeding on anticoagulation
Vomiting blood or coffee-ground emesis
Black or tarry stools (melena)
Sudden severe headache
Unexpected large bruising
References
Guidelines and key sources
Kawasara A et al. — Management of Coronary Artery Aneurysms
JACC Cardiovascular Interventions 2018
Comprehensive management framework for CAA
PCI techniques including covered stent and coil embolization
PMID 29976357
Primary reference for CAA classification and treatment algorithms
Guides percutaneous intervention planning
Nunez-Gil IJ et al. — International CAAR Registry
International Journal of Cardiology 2020
1,729-patient registry with 44.8-month follow-up
22% mortality; local complications approximately 2%
PMID 31378382
Largest prospective registry for CAA natural history
MACE driven by atherosclerotic burden, not aneurysm per se
McCrindle BW et al. — AHA Kawasaki Disease Scientific Statement
Circulation 2017
Diagnosis, treatment, and long-term management of Kawasaki disease
IVIG 2 g/kg and aspirin dosing recommendations
AHA Scientific Statement — foundational pediatric CAA reference
Z-score-based aneurysm grading and antithrombotic stratification
Lifelong surveillance guidelines
Jone PN et al. — AHA 2024 Kawasaki Disease Update
Circulation 2024
Updated guidance on diagnosis and management
DOACs emerging as alternatives in pediatric giant aneurysm
AHA 2024 Scientific Statement
Most current evidence base for Kawasaki-related CAA
Reflects evolving antithrombotic evidence
Sannino M et al. — CAAR Long-Term Prognosis
JACC Cardiovascular Interventions 2024
Long-term outcomes from CAAR registry
Predictors of MACE including CKD and peripheral artery disease
PMID 39603781
Guides risk stratification and surveillance intensity
Virani SS et al. — 2023 AHA/ACC Chronic Coronary Disease Guideline
Journal of the American College of Cardiology 2023
Class I recommendations for antiplatelet and statin therapy
LDL-C target < 1.8 mmol/L for established CAD
Comprehensive chronic CAD management framework
Risk factor optimization evidence base
Fang CT et al. — Epidemiology and Risk Factors of CAA in Taiwan
BMJ Open 2017
Population-based case-control study
Adjusted odds ratios for CAA risk factors (atherosclerosis aOR 7.97)
PMID 28667203
Primary epidemiologic reference for risk factor associations
Jeudy J et al. — Spectrum of Coronary Artery Aneurysms (Radiographics)
Radiographics 2018
Morphological classification and imaging characteristics
CT and MRI protocols for CAA evaluation
PMID 29320324
Radiologic-pathologic correlation for CAA morphology
Giglia TM et al. — AHA Thrombosis in Pediatric and Congenital Heart Disease
Circulation 2013
Anticoagulation protocols for pediatric CAA
Weight-based LMWH dosing and monitoring
AHA Scientific Statement — pediatric antithrombotic reference
Anti-Xa therapeutic ranges for pediatric patients
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.