Lesion left main coronary artery and / or multivessel coronary artery disease

Abstract

The article describes the clinical and electrocardiograph|y features of the lesion left main coronary artery (LMCA). LMCA stenosis of more than 50% allows to classificated such patients as a high risk of sudden death, which occurs 3-4 times more often compared with coronary artery disease in other localizations. Another feature characteristic of this category of patients is the presence of multifocal atherosclerosis (MFA). In patients without carotid stenosis, LMCA lesions are detected in 5% of cases, while in patients with MFA (with lesions of the carotid arteries) - in 40%. Despite some clinical signs that allow the patient to suspect the presence of LMCA, the most informative and reliable method is invasive coronary angiography (CAG). Evaluation of CAG using fractional flow reserve (FFR) and intravascular ultrasound (IVUS) help to improve the diagnosis of the degree of LMCA stenosis, assess the nature of the plaque, the true diameter of the vessel and is an important step towards early myocardial revascularization. The article also presents the clinical analysis of lectrocardiogram with lesions of LMCA and multivessel lesions of the coronary arteries (three vessels or more).