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Total occlusion of the left main coronary artery in chronic stable angina pectoris
K Sudhir1, A K Abraham, M K Cherian
1Southern Railway Headquarters Hospital, Perambur, Madras, India.
Insights
Stable angina patients with significant risk factors can unexpectedly have total left main coronary artery occlusion. This finding highlights the need for thorough coronary angiography even in early-stage stable angina.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Stable angina pectoris is typically associated with less severe coronary artery disease.
- Early-stage angina (Class I) often presents with minimal symptoms and risk factors.
Observation:
- Three patients with Class I stable angina and significant coronary risk factors were evaluated.
- All patients exhibited positive stress test results at stage one of the Bruce protocol.
Findings:
- Coronary angiography revealed total occlusion of the left main coronary artery (LMCA) in all three patients.
- Despite mild angina symptoms, severe LMCA disease was identified.
Implications:
- Total LMCA occlusion can occur unexpectedly in patients with early-stage stable angina.
- This underscores the importance of comprehensive coronary angiography in evaluating patients with angina, regardless of symptom severity.
- Aortocoronary bypass surgery was successfully performed in all cases, indicating a viable treatment option.
Abstract:
We present the clinical and angiographic profile of three patients with class I stable angina pectoris. All had strong coronary risk factors, and stress testing was positive in stage one of the Bruce protocol. Coronary angiography revealed total occlusion of the left main coronary artery (LMCA), and aortocoronary bypass surgery was performed. Thus, total LMCA occlusion may be an unexpected angiographic finding in patients with class I angina.