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Left Main Coronary Artery Compression During Primary Pulmonary Hypertension

Jean-Frédéric Patrat; Guillaume Jondeau; Olivier Dubourg; Pascal Lacombe; Michel Rigaud; Jean-Pierre Bourdarias; Iradj Gandjbakhch
Author and Funding Information

Affiliations: From the Department of Cardiology, Hôpital Ambroise Paré, Boulogne, France,  From the Department of Radiology, Hôpital Ambroise Paré, Boulogne, France,  From the Department of Cardiac Surgery, Hôpital de la Pitié Boulogne, France

Affiliations: From the Department of Cardiology, Hôpital Ambroise Paré, Boulogne, France,  From the Department of Radiology, Hôpital Ambroise Paré, Boulogne, France,  From the Department of Cardiac Surgery, Hôpital de la Pitié Boulogne, France

Affiliations: From the Department of Cardiology, Hôpital Ambroise Paré, Boulogne, France,  From the Department of Radiology, Hôpital Ambroise Paré, Boulogne, France,  From the Department of Cardiac Surgery, Hôpital de la Pitié Boulogne, France


1997 by the American College of Chest Physicians


Chest. 1997;112(3):842-843. doi:10.1378/chest.112.3.842
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Abstract

Primary pulmonary hypertension (PPH) is often associated with angina-like chest pain, the mechanism of which is controversial. A 37-year-old woman with severe PPH and angina had transient ischemic ECG changes and reversible anterior perfusion defect on 201thallium scintigraphy. Coronary angiography revealed severe stenosis of the left main coronary artery (LMCA) and otherwise normal vessels. After heart-lung transplantation, examination of the explanted heart showed normal coronary arteries. Compression of the LMCA by the dilated pulmonary artery trunk was responsible for myocardial ischemia. This mechanism should be considered in patients with PPH and angina and might contribute to the high sudden death rate.


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