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

• Published in: Radiology case reports Vol. 16; no. 3; pp. 714 - 717
• Main Authors: Yamamoto, Takashi, Yamashita, Kentaro, Hagiwara, Hiroaki, Nakayama, Tomohiro, Sakai, Akihiro, Miyamae, Kiichi, Kunieda, Takeshige, Kamimura, Yoshihiro, Hayakawa, Satoko, Mori, Kazutaka, Yamada, Takaaki, Tomita, Yasushi
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.03.2021; Elsevier
• Subjects: Case Report; Cystic mass; External compression; Mediastinal tumor; Myocardial infarction; Schwannoma; Myocardial infarction; Cystic mass; External compression; Mediastinal tumor; Schwannoma
• ISSN: 1930-0433; 1930-0433
• DOI: 10.1016/j.radcr.2021.01.005

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.