Isolated and severe left main coronary ostial stenosis is a rare case. In the majority of these patients ostial stenosis was associated with any of the conditions known to involve the coronary ostia. These conditions include syphilitic aortitis, Takayasu's aortitis, familial hypercholesterolemia, and aortic valve disease. A 34-year young female patient was presented with exertional and stabbing anterior chest pain. There was no history of syphilis, diabetes mellitus, hypertension, hyperlipidemia and smoking. Coronary angiogram showed isolated left main coronary ostial stenosis. Transesophageal echocardiography(TEE) showed acute angle takeoff of the left main coronary artery. She underwent surgical angioplasty of coronary ostia with a patch of autologous pericardium. After angioplasty, TEE showed dilatation of left main coronary ostium and her clinical symptom improved.
Angioplasty ; Aortic Valve ; Aortitis ; Chest Pain ; Constriction, Pathologic* ; Coronary Vessels ; Diabetes Mellitus ; Dilatation ; Female ; Humans ; Hyperlipidemias ; Hyperlipoproteinemia Type II ; Hypertension ; Pericardium ; Smoke ; Smoking ; Syphilis ; Syphilis, Cardiovascular

No abstract available.
Angioplasty* ; Constriction, Pathologic* ; Echocardiography, Transesophageal* ; Humans

Spontaneous coronary artery embolization is a known complication of infective endocarditis. However, a microembolism from the aortic valve into the left anterior descending artery resulting in an acute anterior myocardial infarction is very rare. A 44-year-old male patient suffered from chest pain and fever of seven days duration. The echocardiogram demonstrated severe aortic stenosis, aortic root abscess and mobile vegetation on bicuspid aortic valve near the left coronary artery ostium. The electrocardiogram revealed ST segment elevation in lead V1-3 and heart enzyme analysis showed LD 936 IU/L, CK 299 IU/L, CK-MB 7.2 U/L, Troponin I 9.94 ng/mL. Diagnostic coronary angiogram revealed insignificant coronary lesion. Emergent operation was required because of aortic root abscess formation and high risk of recurrent embolization. He underwent surgery for aortic valve replacement and conservative management for acute myocardial infarction. The purpose of this article is to report the successful emergent aortic valve replacement of a patient with myocardial infarction due to coronary microembolism in a case of bacterial endocarditis.
Abscess ; Adult ; Aortic Valve ; Aortic Valve Stenosis ; Arteries ; Bicuspid ; Chest Pain ; Coronary Vessels ; Electrocardiography ; Endocarditis ; Endocarditis, Bacterial* ; Fever ; Heart ; Humans ; Male ; Myocardial Infarction* ; Troponin I