Open AccessLeft Main Coronary Artery Compression in Pulmonary Arterial Hypertension
Author(s) -
Albadri Kadhem,
Jensen Jesper M.,
Christiansen Evald H.,
Mellemkjær Søren,
NielsenKudsk Jens Erik
Publication year - 2015
Publication title -
pulmonary circulation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.791
H-Index - 40
ISSN - 2045-8940
DOI - 10.1086/683690
Subject(s) - medicine , cardiology , pulmonary artery , pulmonary hypertension , artery
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.