Left Main Coronary Artery Compression in Pulmonary Hypertension: Value of Multimodality Imaging in Diagnosis and Treatment.

Left main coronary artery (LMCA) extrinsic compression should be suspected in patients with pulmonary hypertension and angina. Coronary angiography and intracoronary imaging are complementary techniques to confirm the diagnosis and guide therapy. In the largest prospective single-center series, the prevalence of a significant LMCA stenosis >50% due to dilated pulmonary artery-induced extrinsic compression was 6% in the pulmonary arterial hypertension population, and increased to 40% in patients with angina-like symptoms.