Total occlusion of the left main coronary artery is rare. Acute occlusion is invariably fatal; however, survival is possible if the patient reaches the hospital in time. Patients usually present with acute myocardial infarction, cardiogenic shock, and sudden cardiac death. Chronic total occlusion presents with angina, myocardial infarction, or congestive heart failure. The authors describe complete occlusion of the left main coronary artery in a patient who presented with recent-onset angina. They review the clinical and angio graphic features of 60 cases described in the literature.
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