Ogiso Masataka, Serizawa Naoki, Kamishima Kazuho, Yamaguchi Junichi, Hagiwara Nobuhisa
Department of Cardiology, Tokyo Women's Medical University, Japan.
Intern Med. 2015;54(7):801-4. doi: 10.2169/internalmedicine.54.3528. Epub 2015 Apr 1.
A 60-year-old woman presented with ST-elevation myocardial infarction due to extrinsic compression of the left main coronary artery (LMCA) caused by a dilated pulmonary artery (PA) with idiopathic pulmonary hypertension and was successfully treated with intravascular ultrasound- and optical coherence tomography-guided stenting. Continuous subcutaneous epoprostenol infusion therapy was initiated immediately after the procedure and increased aggressively. Imaging modalities were extremely useful in making the diagnosis and providing follow-up of LMCA compression syndrome in this case. Over the one-year observation period, a sufficient hemodynamic improvement was obtained, without exacerbation of the PA dilatation, resulting in the absence of compression of the LMCA.
一名60岁女性因特发性肺动脉高压导致肺动脉扩张，压迫左冠状动脉主干（LMCA），进而引发ST段抬高型心肌梗死，经血管内超声和光学相干断层扫描引导下支架置入术成功治疗。术后立即开始持续皮下输注依前列醇，并积极增加剂量。在该病例中，影像学检查对于诊断和随访LMCA压迫综合征极为有用。在一年的观察期内，血流动力学得到充分改善，肺动脉扩张未加重，LMCA未再受压。
