Left coronary artery compression syndrome is characterized by compression of the left main coronary artery between the aorta and an enlarged main pulmonary artery. A 39-year-old woman presented with angina with dyspnea on exertion for two years. Detailed investigations revealed an atrial septal defect, valvular lesions, and severe pulmonary hypertension with left main coronary artery compression. Patch closure of the atrial septal defect, left coronary artery bypass, and valve repair was carried out. The patient recovered well and was asymptomatic on follow-up. The optimal management of such patients is yet to be clarified.
CordayEGoldHKaplanL.Coronary artery compression an explanation for the cause of coronary insufficiency in pulmonary hypertension. Trans Am Coll Cardiol1957;
7: 93–103.
2.
JoYKawamuraAJinzakiM, et al.
Extrinsic compression of left main coronary artery by Atrial septal defect.Ann Thoracic Surg2008;
86: 1987–1989.
3.
PiñaYExaireJESandovalJ.Left main coronary artery compression syndrome: a combined intravascular ultrasound and pressure wire report. J Invasive Cardiol2006;
18: E102–E104.
4.
HultenEVillinesTCCheezumMK, et al.
Usefulness of coronary computed tomography angiography to predict mortality and myocardial infarction among Caucasian, African and East Asian ethnicities (from the CONFIRM [Coronary CT Angiography Evaluation for Clinical Outcomes: an International Multicenter] Registry). Am J Cardiol2013;
111: 479–485.
5.
SafiMEslamiVShabestariA, et al.
Extrinsic compression of left main coronary artery by pulmonary trunk secondary to pulmonary hypertension documented using 64 slice multidetector computed coronary arteriography.Clin Cardiol2009;
32(8): 426–428.
6.
GalièNSaiaFPalazziniM, et al.
Left main coronary artery compression in patients with pulmonary arterial hypertension and angina.J Am Coll Cardiol2017;
69: 2808–2817.
7.
FujiwaraKNaitoYHigashiueS, et al.
Left main coronary trunk compression by dilated main pulmonary artery in atrial septal defect. Report of three cases. J Thorac Cardiovasc Surg1992;
104: 449–452.
8.
RichSMcLaughlinVVO’NeillW.Stenting to reverse left ventricular ischemia due to left main coronary artery compression in primary pulmonary hypertension.Chest2001;
120: 1412–1415.
