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Neoplastic angina: a case report
H L White1, M J Brack, R W Millner
1Blackpool Victoria Hospital, Lancashire, UK.
Insights
Aortic paraganglioma compressing the left main coronary artery caused exertional angina in a 54-year-old woman. Surgical intervention and coronary artery bypass grafting resolved her symptoms, demonstrating effective treatment for this rare condition.
Area of Science:
- Cardiovascular Medicine
- Surgical Oncology
- Diagnostic Imaging
Background:
- Exertional angina is a common symptom of coronary artery disease.
- Aortic paragangliomas are rare neuroendocrine tumors arising from the aortic root.
- Left main coronary artery stenosis significantly increases cardiovascular risk.
Observation:
- Coronary angiography revealed unusual capillary blushing around a left main stem stenosis.
- Intraoperative visualization identified a mass originating from the aortic root, encasing the left main stem.
Findings:
- Histopathological examination confirmed the mass as an aortic paraganglioma.
- The tumor's location caused significant stenosis of the left main coronary artery.
Implications:
- This case highlights the importance of considering rare tumors in the differential diagnosis of coronary artery stenosis.
- Successful surgical management, including coronary artery bypass grafting, can provide long-term symptom relief.
- Early diagnosis and intervention are crucial for managing complications associated with aortic paragangliomas.
Abstract:
A 54-year-old Caucasian woman, with a 1-year history of exertional angina was investigated by means of coronary angiography. On injection of contrast into both coronary arteries an unusual area of capillary blushing was seen around the point of a left main stem stenosis. At surgery a mass was seen arising from the area of the aortic root extending around the left main stem. Histology confirmed this to be an aortic paraganglioma. Three-vessel coronary artery bypass grafting was performed and at 6-month follow-up the patient remained symptom free.