Dynamic compression of the left main coronary artery by the left atrium.
We report a case of a 67-year-old woman with a past medical history of severe mitral valve regurgitation with worsening congestive heart failure symptoms and angina. Coronary angiography revealed dynamic limitation of contrast flow during systole in the left main (LM) coronary artery, but no evidence of obstructive atherosclerotic disease. Intravascular ultrasound demonstrated a dynamic distortion and reduction of the LM coronary artery cross sectional area during systole. Cardiac computed tomography demonstrated left atrial enlargement with extrinsic distortion and compression of the LM coronary artery. A diagnosis was made of dynamic compression of the LM coronary artery secondary to systolic left atrial enlargement resulting from mitral regurgitation.
Ducas
Robin A
RA
Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. jducas@sbgh.mb.ca
Jassal
Davinder S
DS
Kirkpatrick
Iain D C
ID
Freed
Darren H
DH
Zieroth
Shelley R
SR
Ducas
John
J
D000368:Aged; D003330:Coronary Vessel Anomalies / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D008944:Mitral Valve Insufficiency; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography