Left main coronary artery compression by a dilated pulmonary artery

Pulmonary artery hypertension is often associated with chest pain. The etiology of chest pain has been reported as the dilatation of the pulmonary artery or right ventricular hypertrophy and ischemia. However, extrinsic left main coronary artery (LMCA) compression by pulmonary artery enlargement is another important cause of chest pain. The incidence of LMCA compression by dilated pulmonary artery is not well known. However, the clinical presentations sometimes might be cardiogenic shock and malignant arrhythmia due to myocardial ischemia and sudden death. The optimal management for pulmonary hypertension patients with extrinsic LMCA compression has not been clearly established. Here, we described a case of patient presenting extrinsic compression of the LMCA with severe pulmonary artery hypertension, who was treated with stent implantation.