Total occlusion of the left main coronary artery in chronic stable angina pectoris

Sudhir, Krishnankutty; Abraham, Abraham K.; Cherian, Maman K.; Reddy, N K; Gupta, Srikrishna

doi:10.1002/ccd.1810130507

Cited by 6 publications

(2 citation statements)

References 7 publications

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“…On ECG a horizontal or oblique downward depression with deep negative T waves during stenocardial pain is supposed to be characteristic of patients with a LMCA stenosis and may be present in 70% of such patients [11]. Exercise tolerance tests show significant ischemic changes in stage one or two of the Bruce protocol persisting long afterward during rest [12]. A steal phenomenon from the right coronary artery region is very often diagnosed: Electrographically this appears similar to a picture of a localized inferior wall myocardial infarction, while in echocardiography it appears as hypokinesis of the right coronary artery region.…”

Section: Discussionmentioning

confidence: 98%

Chronic total left main coronary artery occlusion— A case report

2011

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We report on the clinical and angiographic data of a patient suffering from total chronic occlusion of the left main coronary artery. For many years the patientÕs only complaint was of mild stable angina (CCS I). He had a history of a previous acute myocardial infarction 20 years ago, possibly caused by the occlusion of the left main coronary artery. The anatomic and clinical findings of chronic total occlusion of the left main coronary artery during his life are discussed. Case ReportA 53-year-old man, with a history of an anterior myocardial infarction 20 years ago and stable coronary heart disease (CCS I) till now, was admitted to the hospital for evaluation of a second episode of syncope with preceding chest pain. Troponin tests were negative. The treadmill test revealed shallow ()1.5 mm) ST-segment depression and a weak stenocardial pain at a higher level of exercise (10 METS). Holter electrocardiogram (ECG) did not show any serious cardiac arrhythmias. Transthoracic echocardiography demonstrated normal dimensions of the left ventricle (diastolic, 49 mm; systolic, 32 mm), hypokinesis of the anterior wall and apex, mild mitral regurgitation, and an ejection fraction of about 50%. The angiography showed a chronic total left main coronary artery (LMCA) occlusion ( Figure 1) and a dominant right coronary artery, which had distal segment stenosis (Figure 2). The proximal part of the right coronary artery was connected with the proximal left coronary artery by a collateral anastomosis (Figure 3A and B). The left descending artery and the circumflex artery were both supplied by this collateral vessel. The patient underwent coronary bypass surgery in which the internal thoracic artery was anastomosed to the left anterior descending artery and separate saphenous vein grafts were connected to the marginal branch and posterior descending artery. The patient made a full recovery.

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Section: Discussionmentioning

confidence: 98%

Chronic total left main coronary artery occlusion— A case report

2011

View full text Add to dashboard Cite

show abstract

“…On ECG a horizontal or oblique downward depression with deep negative T waves during stenocardial pain is supposed to be characteristic of patients with a LMCA stenosis and may be present in 70% of such patients [11]. Exercise tolerance tests show significant ischemic changes in stage one or two of the Bruce protocol persisting long afterward during rest [12]. A steal phenomenon from the Case Reports right coronary artery region is very often diagnosed: Electrographically this appears similar to a picture of a localized inferior wall myocardial infarction, while in echocardiography it appears as hypokinesis of the right coronary artery region.…”

Section: Discussionmentioning

confidence: 99%