Left main coronary artery compression syndrome and spontaneous coronary artery dissection: coincidence or pathologic association?

Heart Lung. 2014 Jul-Aug;43(4):284-5. doi: 10.1016/j.hrtlng.2014.03.008. Epub 2014 Apr 21.

Abstract

Left main coronary artery compression syndrome (LMCS) in patients with severe pulmonary arterial hypertension (PAH) is an unusual, and often a missed cause of exertional angina. Spontaneous coronary dissection (SCD) is a rare cause of acute coronary syndrome of unknown etiology, with predilection to women in the 20s-40s. Weather the co-presence of LMCS and SCD in certain patients is a coincidence or of pathological significance is not known. The optimal management strategy of each of these conditions remains controversial. We report a case of SCD in a patient with PAH and LMCS, successfully treated with conservative medical therapy.

Keywords: Cardiac computed tomography; Intravascular ultrasound; Left main compression; Pulmonary artery dilatation; Pulmonary hypertension; Spontaneous coronary dissection.

Publication types

  • Case Reports

MeSH terms

  • Acute Coronary Syndrome / etiology*
  • Adult
  • Aortic Dissection / complications*
  • Chest Pain / etiology
  • Coronary Angiography
  • Coronary Stenosis / complications*
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / drug therapy
  • Familial Primary Pulmonary Hypertension
  • Female
  • Humans
  • Hypertension, Pulmonary / complications*
  • Hypertension, Pulmonary / drug therapy
  • Platelet Aggregation Inhibitors / therapeutic use
  • Pulmonary Artery / pathology

Substances

  • Platelet Aggregation Inhibitors