Introduction: Coronary artery disease involving the left main stem is an extremely uncommon during adolescent life. Etiologies for such an occurrence may be congenital or acquired, that may be mainly of inflammatory in origin. Case Report: A 14 year old girl presented with acute extensive anterior myocardial infarction and cardiogenic shock. Selective coronary angiography showed isolated near total occlusion of ostial and proximal segments of left main coronary artery with dominant right coronary system, which is free of disease. Emergency Percutaneous Coronary Intervention (PCI) was performed with Evarolimus eluting coronary stent system with re-establishment of left sided coronary blood flow. She showed marked improvement following PCI and was discharged on the 7 th day of admission. Conclusion: PCI can be promising intervention for acute total or subtotal occlusion of LMCA even in adolescents, though it is technically challenging.
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