Acute coronary syndromes (ACS) are defined by a sudden reduction in blood supply to the heart, and an estimated more than seven million people are diagnosed with ACS worldwide.1 To date, rupture of lipid-laden atherosclerotic plaque was recognized as the main cause of ACS, while some other uncommon causes had been relatively less known by clinicians, such as coronary anomalies, autoimmune diseases and vasculitis.23 Coronary arteritis was a rare and life-threatening cause of coronary artery disease, which often occurred in young patients represented as atypical acute ACS. Typically, coronary arteritis was categorized as coronary involvement in systematic vasculitis or isolated coronary vasculitis.4 Compared with atherosclerotic cardiovascular disease (ASCVD), high recurrent myocardial infarction (RMI) and in-stent restenosis (ISR) after treatment as conventional ASCVD raised in coronary vasculitis.4 Most of these patients lacked of conventional factors for ISR or RMI, including lesion complexity (eg, bifurcation lesions, total occlusion), complications of the procedure (eg, incomplete expansion of stent, abrupt closure during stent implantation), stent-related factors (eg, overlength or small diameter of stents) and patient characteristics (eg, diabetes, chronic kidney disease, left ventricular insufficiency).5

To improve the accuracy of diagnosis and efficient of management in coronary arteritis, we did this review to identified specific clinical manifestations, imaging finding, laboratory results and therapeutic strategy in coronary arteritis.