Rare disease
Differential diagnosis of non-atherosclerotic left main coronary artery stenosis
1 Berufsgenossenschaftliche Universitätsklinik Bergmannsheil, Medizinische Klinik II,Kardiologie und Angiologie, Bürkle-de-la-Camp-Platz 1, Bochum, 44789, Germany
2 Berufsgenossenschaftliche Universitätsklinik Bergmannsheil, Clinic for Cardiothoracic Surgery, Bürkle-de-la-Camp-Platz 1, Bochum, 44789, Germany
3 Johannes Hospital Dortmund, Department of Medicine, Hematology and Oncology, Johannesstraße 9-17, Dortmund, 44137, Germany
4 Berufsgenossenschaftliche Universitätsklinik Bergmannsheil, Institute of Pathology, Bürkle-de-la-Camp-Platz 1, Bochum, 44789, Germany
Correspondence to:
michael_gotzmann{at}web.de
A left main coronary artery (LMCA) stenosis without any atherosclerotic changes elsewhere in the coronary artery tree is a rare finding, and some uncommon reasons for luminal narrowing should be considered. An unusual case of non-atherosclerotic LMCA stenosis is reported.
A middle-aged patient presented with acute myocardial infarction. An immediate coronary angiography was ordered and revealed a subtotal mid LMCA stenosis. A drug-eluting stent was successfully implanted in the LMCA.
Operative revascularisation was recommended. Routine surgery was performed and surprisingly revealed an extended mass of a mediastinal tumour surrounding the aortic root. Histopathological examination of the tumour revealed a poorly differentiated squamous cell carcinoma.
Postoperatively, the patient was treated with chemotherapy (carboplatin and docetaxel). Five years after the first admission to our hospital, the patient died as a result of ventricular fibrillation.
The differential diagnosis of non-atherosclerotic LMCA stenoses is discussed.
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