Key result
Percutaneous coronary intervention with stent implantation successfully treated a patient with severe angina due to extrinsic compression of the left main coronary artery.
Case Report (n=1)
Extrinsic compression of the LMCA by a dilated pulmonary artery is a potentially fatal complication in PAH patients with angina that can be diagnosed with MDCT and treated with PCI.
Suggests PCI feasibility for extrinsic left main compression; hypothesis-generating and needs prospective validation before changing practice.
In patients with pulmonary arterial hypertension (PAH), chest pain is most likely due to right ventricular demand ischemia. We report a patient with idiopathic PAH who developed severe angina due to extrinsic compression of the left main coronary artery (LMCA) from a dilated pulmonary artery trunk. The diagnosis was verified by electrocardiogram after exercise, coronary angiography including intravascular ultrasound, and cardiac multidetector computed tomography (MDCT). The origin of the LMCA was high in the left coronary sinus, facilitating extrinsic compression. The patient was successfully treated by percutaneous coronary intervention with stent implantation in the LMCA. Extrinsic compression of the LMCA is a severe and potentially fatal complication that should be considered in all patients with PAH and angina. MDCT is the method of choice for first-line diagnosis.
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Al-Badri et al. (2015) conducted a case report in Pulmonary arterial hypertension (n=1). Percutaneous coronary intervention with stent implantation was evaluated. Percutaneous coronary intervention with stent implantation successfully treated a patient with severe angina due to extrinsic compression of the left main coronary artery.
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