Acute coronary syndrome due to extrinsic compression of the left main coronary artery in a patient with severe pulmonary hypertension: successful treatment with percutaneous coronary intervention

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Abstract

A patient with severe pulmonary (arterial) hypertension (PH) presented with a non-ST segment elevation myocardial infarction and recurrent angina at rest. Coronary angiography showed severe ostial left main coronary artery (LMCA) stenosis; coronary arteries were otherwise normal. Intravascular ultrasonography (IVUS) showed deformation of the LMCA due to extrinsic compression from a markedly dilated main pulmonary artery, which was confirmed by cardiac computed tomography. The LMCA was successfully stented using a paclitaxel-eluting stent resulting in complete resolution of angina. Extrinsic compression of the LMCA should be considered in patients with severe PH and angina; IVUS may aid in the diagnosis. Percutaneous stent implantation may be the preferred treatment in this high-risk group of patients.

Original languageEnglish (US)
Pages (from-to)47-51
Number of pages5
JournalCardiovascular Revascularization Medicine
Volume9
Issue number1
DOIs
StatePublished - Jan 2008

Fingerprint

Percutaneous Coronary Intervention
Acute Coronary Syndrome
Pulmonary Hypertension
Coronary Vessels
Interventional Ultrasonography
Stents
Coronary Stenosis
Unstable Angina
Therapeutics
Paclitaxel
Coronary Angiography
Pulmonary Artery
Tomography

Keywords

  • Coronary artery stenting
  • Left main coronary stenosis
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Molecular Medicine
  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

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abstract = "A patient with severe pulmonary (arterial) hypertension (PH) presented with a non-ST segment elevation myocardial infarction and recurrent angina at rest. Coronary angiography showed severe ostial left main coronary artery (LMCA) stenosis; coronary arteries were otherwise normal. Intravascular ultrasonography (IVUS) showed deformation of the LMCA due to extrinsic compression from a markedly dilated main pulmonary artery, which was confirmed by cardiac computed tomography. The LMCA was successfully stented using a paclitaxel-eluting stent resulting in complete resolution of angina. Extrinsic compression of the LMCA should be considered in patients with severe PH and angina; IVUS may aid in the diagnosis. Percutaneous stent implantation may be the preferred treatment in this high-risk group of patients.",
keywords = "Coronary artery stenting, Left main coronary stenosis, Pulmonary hypertension",
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AB - A patient with severe pulmonary (arterial) hypertension (PH) presented with a non-ST segment elevation myocardial infarction and recurrent angina at rest. Coronary angiography showed severe ostial left main coronary artery (LMCA) stenosis; coronary arteries were otherwise normal. Intravascular ultrasonography (IVUS) showed deformation of the LMCA due to extrinsic compression from a markedly dilated main pulmonary artery, which was confirmed by cardiac computed tomography. The LMCA was successfully stented using a paclitaxel-eluting stent resulting in complete resolution of angina. Extrinsic compression of the LMCA should be considered in patients with severe PH and angina; IVUS may aid in the diagnosis. Percutaneous stent implantation may be the preferred treatment in this high-risk group of patients.

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