STEMI From Left Main Compression by Pulmonary Artery Aneurysm Diagnosed With IVUS.

ABSTRACT:

Background

Left main coronary artery compression (LMCo) by a dilated pulmonary artery is a rare but potentially fatal complication of pulmonary arterial hypertension (PAH).

Case

An octogenarian man with asthma and PAH presented with dyspnea and developed pulseless ventricular tachycardia. Electrocardiogram showed ST-segment elevation in leads I, aVL, and V₄ to V₆. Angiography revealed 99% stenosis of the proximal left main trunk. Intravascular ultrasound (IVUS) showed slit-like compression without plaque. A 3.5- × 15-mm drug-eluting stent was implanted, restoring TIMI flow grade 3. Subsequent computed tomography demonstrated a 73-mm pulmonary artery adjacent to the left main trunk (pulmonary artery/aorta ratio: 2.28), confirming LMCo. Despite intra-aort

SUBMITTER: Endo T 

PROVIDER: S-EPMC12789790 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature