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Left Main Coronary Artery Compression by Pulmonary Aneurysm

Imaging findings

Coronary CT angiography and catheter angiography demonstrate severe pulmonary arterial hypertension with a giant pulmonary artery aneurysm. The dilated pulmonary artery compresses the origin of the left main coronary artery, causing severe ostial stenosis.

Key takeaways

Left main coronary artery compression is a known, serious complication of giant pulmonary artery aneurysms in severe pulmonary hypertension. The dilated pulmonary trunk exerts extrinsic mass effect on the left main coronary ostium, causing angina or ischemia.

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