Pulmonary hypertension is a major health problem with increasing awareness. Although most common cause of PH is left heart disease (group 2 PH), life-threatening complications occur mostly in groups 1 (pulmonary arterial hypertension) and group 4 (chronic thromboembolic pulmonary hypertension) patients. However, external compression of left main coronary artery (LMCA) due to pulmonary artery dilatation is rare, but it is a life-threatening complication since it causes myocardial ischemia and sudden cardiac death. In addition, pulmonary hypertension is more than a single clinical entity, it has a complex mechanism in which more than one subgroup may develop over time in the same patient. This complex mechanism challenges us when diagnosing the patient and faces us with life-threatening complications.
In this case; we report a PAH patient applied to our clinic with progressive dyspnea and recent angina, after detection of LMCA ostial stenosis, the patient was treated with IVUS guided stent implantation. In the further follow-ups, the patient underwent the pulmonary endarterectomy operation due to the diagnosis of CTEPH secondary to newly diagnosed primary antiphospholipid syndrome.
Copyright © 2023 Archives of the Turkish Society of Cardiology