Unusual Case of Acute Coronary Syndrome Due to Compression of the Left Main Coronary Artery From a Contained Aortic Root Perforation

We present an intriguing and rare case of a 71-year-old male who presented with a non-ST elevation myocardial infarction (NSTEMI). Initial coronary angiography revealed severe and unusual systolic extrinsic compression of the left main coronary artery (LM), warranting further advanced imaging invest...

Full description

Saved in:
Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-08, Vol.15 (8)
Main Authors: Molina-Lopez, Victor H, Diaz-Rodriguez, Porfirio E, Rivera-Torres, Juan J, Vazquez-Fuster, Juan, Maldonado-Suarez, Joseph, Vicenty-Rivera, Sonia
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Angina pectoris
Cardiac/Thoracic/Vascular Surgery
Cardiology
Case reports
Clinical outcomes
Collaboration
Congenital diseases
Coronary vessels
Disease
Electrocardiography
Endocarditis
Hypertension
Interdisciplinary aspects
Ischemia
Medical imaging
Patients
Prostheses
Pseudoaneurysm
Pulmonary arteries
Ultrasonic imaging
Veins & arteries
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We present an intriguing and rare case of a 71-year-old male who presented with a non-ST elevation myocardial infarction (NSTEMI). Initial coronary angiography revealed severe and unusual systolic extrinsic compression of the left main coronary artery (LM), warranting further advanced imaging investigations. Computed tomography angiography (CTA) and transesophageal echocardiography (TEE) were employed to determine the underlying cause, which was identified as a contained aortic rupture leading to the formation of a pseudoaneurysm in the left coronary sinus of Valsalva and aortic root. This condition was found to be a sequela of previously undiagnosed endocarditis, likely secondary to lower extremity osteomyelitis and bacteremia, for which the patient received prolonged intravenous (IV) antibiotic therapy. This case highlights the critical role advanced imaging techniques play in accurately diagnosing and characterizing complex cardiovascular abnormalities, enabling early intervention and optimizing patient outcomes. Healthcare providers should remain vigilant for such atypical presentations to ensure timely and appropriate management.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.43492