Submitted to the New England Journal of Medicine
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Left Main Artery Compression
Journal:
Manuscript ID:
11-04706 Image in Clinical Medicine
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Article Type:
New England Journal of Medicine
Date Submitted by the Author:
Keywords:
Cardiology
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Abstract:
DOYEN, Denis; Hospital Pasteur, Cardiology FERRARI, Emile; Hospital Pasteur, Cardiology
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Complete List of Authors:
21-Apr-2011
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Left Main Artery Compression Denis Doyen, Emile Ferrari Department of Cardiology, Hospital Pasteur, Nice, France (D Doyen MD, E Ferrari MD) Dr E Ferrari, Cardiology, Hospital Pasteur, Tel : 0033492037880, Fax : 0033492037879,
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[email protected],
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Correspondance to: Dr D Doyen, Cardiology, Hospital Pasteur, 30 avenue de la voie Romaine, 06002 Nice, France, Tel : 0033678992938, Fax : 0033492037879,
[email protected] Conflicts of interest :
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E Ferrari : none
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D Doyen : none
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No potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
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Concerning panels A and B, patient’s informations were digitally erased.
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Submitted to the New England Journal of Medicine
Confidential: Destroy when review is complete.
Submitted to the New England Journal of Medicine
A 61-year-old man with a known primary pulmonary hypertension (PHT) presented with angina while lying on the back and was relieved by left lateral decubitus. Coronary multidetector-computed-tomography showed a major dilation of the pulmonary artery trunk (Panel A, arrow) giving rise to left main artery compression (Panel B, arrow), which was confirmed by coronarography (Panel C, arrow). Angioplasty was performed resulting in complete
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removal of the chest pain. Such stenosis due to dilation of the pulmonary artery in PHT is not a recent finding but has seldom been described. The position-related character of angor which
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disappears when the patient turns on his left side can be explained by a change in the
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anatomic relationship between the aneurismal pulmonary artery weighing on the left main
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artery. Such stenosis may be underestimated and could partially explain chest pain often described with PHT, particularly when it changes with position.
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Submitted to the New England Journal of Medicine
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Submitted to the New England Journal of Medicine
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