Ostial left main coronary stenosis in a frequent flyer.
A 52 year old gentleman presented with chest pain, after a long distance flight from India; he had made long haul flights every 2 weeks over the last 5 years as part of his job. His ECG revealed T wave inversion in leads V1-3. Cardiac biomarkers including troponin were negative; we proceeded to exercise stress testing (EST). This revealed 2 mm ST depression at 2 min of the standard Bruce protocol, associated with chest pain. He was taken immediately to the coronary catheterization laboratory; engagement of the left main caused pressure damping with 6 French, then 5 French diagnostic Judkins left 4 catheters. An ostial left main stenosis was seen; the right and left coronary trees otherwise had no significant stenoses. He had normal LV function. He underwent inpatient CABG 7 days later.
O'Sullivan
John F
JF
McFadden
Eugene
E
D000401:Aircraft; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012993:Solar Energy; D014195:Travel