title: Differential diagnosis of non-atherosclerotic left main coronary artery stenosis.
abstract: A left main coronary artery (LMCA) stenosis without any atherosclerotic changes elsewhere in the coronary artery tree is a rare finding, and some uncommon reasons for luminal narrowing should be considered. An unusual case of non-atherosclerotic LMCA stenosis is reported.A middle-aged patient presented with acute myocardial infarction. An immediate coronary angiography was ordered and revealed a subtotal mid LMCA stenosis. A drug-eluting stent was successfully implanted in the LMCA.Operative revascularisation was recommended. Routine surgery was performed and surprisingly revealed an extended mass of a mediastinal tumour surrounding the aortic root. Histopathological examination of the tumour revealed a poorly differentiated squamous cell carcinoma.Postoperatively, the patient was treated with chemotherapy (carboplatin and docetaxel). Five years after the first admission to our hospital, the patient died as a result of ventricular fibrillation.The differential diagnosis of non-atherosclerotic LMCA stenoses is discussed.
authors.affiliation: Berufsgenossenschaftliche Universitätsklinik Bergmannsheil, Medizinische Klinik II,Kardiologie und Angiologie, Bürkle-de-la-Camp-Platz 1, Bochum, 44789, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Gotzmann
authors.forename: Waldemar
authors.initials: W
authors.lastname: Bojara
authors.forename: Alfried
authors.initials: A
authors.lastname: Germing
authors.forename: Andreas
authors.initials: A
authors.lastname: Mügge
authors.forename: Axel
authors.initials: A
authors.lastname: Laczkovics
authors.forename: Christine
authors.initials: C
authors.lastname: Thiessen
authors.forename: Andrea
authors.initials: A
authors.lastname: Tannapfel
authors.forename: Michael
authors.initials: M
authors.lastname: Lindstaedt