TY - JOUR
T1 - Acute coronary syndrome due to extrinsic compression of the left main coronary artery in a patient with severe pulmonary hypertension
T2 - successful treatment with percutaneous coronary intervention
AU - Lindsey, Jason B.
AU - Brilakis, Emmanouil S.
AU - Banerjee, Subhash
PY - 2008/1
Y1 - 2008/1
N2 - 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.
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.
KW - Coronary artery stenting
KW - Left main coronary stenosis
KW - Pulmonary hypertension
UR - http://www.scopus.com/inward/record.url?scp=38149083962&partnerID=8YFLogxK
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U2 - 10.1016/j.carrev.2007.07.003
DO - 10.1016/j.carrev.2007.07.003
M3 - Article
C2 - 18206638
AN - SCOPUS:38149083962
SN - 1553-8389
VL - 9
SP - 47
EP - 51
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
IS - 1
ER -