Extrinsic compression of the left main coronary artery: A rare cause of cardiogenic shock

Takashi Yamamoto, PhD; Kentaro Yamashita, PhD; Hiroaki Hagiwara, PhD; Tomohiro Nakayama, MD; Akihiro Sakai, MD; Kiichi Miyamae, MD; Takeshige Kunieda, MD; Yoshihiro Kamimura, PhD; Satoko Hayakawa, PhD; Kazutaka Mori, PhD; Takaaki Yamada, PhD; Yasushi Tomita, PhD

Radiology Case Reports (Mar 2021)

Extrinsic compression of the left main coronary artery: A rare cause of cardiogenic shock

Takashi Yamamoto, PhD,
Kentaro Yamashita, PhD,
Hiroaki Hagiwara, PhD,
Tomohiro Nakayama, MD,
Akihiro Sakai, MD,
Kiichi Miyamae, MD,
Takeshige Kunieda, MD,
Yoshihiro Kamimura, PhD,
Satoko Hayakawa, PhD,
Kazutaka Mori, PhD,
Takaaki Yamada, PhD,
Yasushi Tomita, PhD

Affiliations

Takashi Yamamoto, PhD: Department of Cardiology, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku Nagoya-shi, Aichi 460-0001, Japan; Corresponding author.
Kentaro Yamashita, PhD: Department of Cardiology, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku Nagoya-shi, Aichi 460-0001, Japan
Hiroaki Hagiwara, PhD: Department of Cardiovascular Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
Tomohiro Nakayama, MD: Department of Cardiovascular Surgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
Akihiro Sakai, MD: Department of Pathology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; Department of Pathology, Nagoya University Graduate School of Medicine, Nagoya, Japan
Kiichi Miyamae, MD: Department of Cardiology, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku Nagoya-shi, Aichi 460-0001, Japan
Takeshige Kunieda, MD: Department of Cardiology, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku Nagoya-shi, Aichi 460-0001, Japan
Yoshihiro Kamimura, PhD: Department of Cardiology, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku Nagoya-shi, Aichi 460-0001, Japan
Satoko Hayakawa, PhD: Department of Cardiology, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku Nagoya-shi, Aichi 460-0001, Japan
Kazutaka Mori, PhD: Department of Cardiology, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku Nagoya-shi, Aichi 460-0001, Japan
Takaaki Yamada, PhD: Department of Cardiology, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku Nagoya-shi, Aichi 460-0001, Japan
Yasushi Tomita, PhD: Department of Cardiology, National Hospital Organization Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku Nagoya-shi, Aichi 460-0001, Japan

Journal volume & issue: Vol. 16, no. 3
pp. 714 – 717

Abstract

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A left main coronary artery (LMCA) stenosis due to extrinsic compression by mediastinal tumor is a rare finding. In this case reports, we present a 63-year-old woman, who was transferred to the emergency department with chief complains of persistent chest and back pain. An electrocardiogram revealed diffuse ST-segment depression (elevation in lead aVR). Contrast-enhanced computed tomography (CT) showed a huge cystic mass above the left atrium. After the CT examination, she was temporarily in shock. Compression of the LMCA was evident on the CT angiography and a diagnosis of acute myocardial infarction due to compression of the LMCA by a tumor was made. An emergent resection of the tumor was performed. Histopathological assessment of the resected cyst revealed that it was a schwannoma. She made an uneventful postoperative recovery. A follow-up 3-dimensional CT scan performed after the operation confirmed no evidence of LMCA compression.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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