Early Percutaneous Coronary Intervention for Unprotected Left Main Disease in Patient with Cardiogenic Shock: A Case-Report

Krupal Reddy

doi:10.4236/wjcd.2016.66018

Abstract

The prognosis of left main coronary artery disease is largely affected by the appropriate selection of the treatment strategy. A 45-year-old male presented with severe chest pain and two episodes of ventricular tachycardia, which was reverted after DC shock. Coronary angiography revealed critical stenotic lesion in the left main coronary artery. The patient successfully underwent urgent angioplasty with stent deployment in the left main coronary artery.

Highlights

Left main coronary artery (LMCA) disease is of significant importance, as left main stem (LMS) is responsible for 84% of the blood supplied to the left ventricle in case of left coronary dominant system [1]
We report a case of 45-year-old male, with hemodynamic instability and subocclusive LMCA lesion, who underwent an early percutaneous coronary intervention (PCI) with a drug-eluting stent resulting in rapid reperfusion of myocardium
Acute occlusion of left main coronary artery is often accompanied by hemodynamic deterioration and cardiogenic shock

Summary

Introduction

Left main coronary artery (LMCA) disease is of significant importance, as left main stem (LMS) is responsible for 84% of the blood supplied to the left ventricle in case of left coronary dominant system [1]. The efficacy and survival benefit of coronary artery bypass grafting (CABG) have established it as the gold standard of care for left main disease [2]-[4]. With recent advances in stent technology and procedure, percutaneous coronary intervention (PCI) warrants prompt reperfusion and restoration of flow without sternotomy, saving the life of patients while maintaining myocardial viability. We report a case of 45-year-old male, with hemodynamic instability and subocclusive LMCA lesion, who underwent an early PCI with a drug-eluting stent resulting in rapid reperfusion of myocardium. (2016) Early Percutaneous Coronary Intervention for Unprotected Left Main Disease in Patient with Cardiogenic Shock: A Case-Report.

Case Report

Procedure

Findings

Discussion