Key result
External LMCA compression by metastatic squamous cell carcinoma causes unstable angina in a 69-year-old male.
Case Report (n=1)
Metastatic tumors can rarely cause severe left main coronary artery narrowing via extrinsic compression, which may present as unstable angina with persistent ST-segment elevation.
Metastatic left main compression may cause unstable angina in cancer patients; hypothesis-generating for rare extrinsic coronary syndromes.
A 69-year-old male with carcinoma of the lung developed unstable angina pectoris during his last few months of life. At necropsy, the coronary arteries were free of atherosclerotic plaque, but the left main artery was severely narrowed by external compression from neoplastic metastases. Persistent anterior ST-segment elevation without evolutionary changes of myocardial infarction was a clue to cardiac involvement by tumor. Direct and indirect effects of metastatic tumors upon the coronary arteries include tumor or thrombi, emboli, wall invasion, or extrinsic wall compression. Extrinsic compression of the left main coronary artery is rare among congenital and acquired conditions producing severe left main disease.
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Weinberg et al. (1990) conducted a case report in Unstable angina pectoris secondary to left main coronary artery narrowing (n=1). External compression by metastatic squamous cell carcinoma was evaluated. External compression of the left main coronary artery by metastatic squamous cell carcinoma caused unstable angina pectoris in a 69-year-old male.
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