Left main coronary artery compression syndrome and spontaneous coronary artery dissection: coincidence or pathologic association?

Abstract Left main coronary artery compression syndrome (LMCS) in patients with severe pulmonary arterial hypertension (PAH) is an unusual, and often a missed cause of exertional angina. Spontaneous coronary dissection (SCD) is a rare cause of acute coronary syndrome of unknown etiology, with predilection to women in the 20s–40s. Weather the co-presence of LMCS and SCD in certain patients is a coincidence or of pathological significance is not known. The optimal management strategy of each of these conditions remains controversial. We report a case of SCD in a patient with PAH and LMCS, successfully treated with conservative medical therapy.