Total Occlusion of the Left Main Coronary Artery in Pulmonary Arterial Hypertension

The development of a pulmonary artery aneurysm (PAA) as a consequence of pulmonary arterial hypertension (PAH) is a rare condition. The dilation of the pulmonary trunk can cause multiple complications, including coronary artery compression. Nevertheless, a total coronary occlusion (TO) without symptoms of coronary ischemia is an extremely unusual circumstance. Herein, we describe a TO of the left main coronary artery (LMCA) discovered in a 23-year-old man with PAH related to an ostium secundum atrial septal defect, in which a 78-mm PAA was detected.