Main left coronary artery disease. Aspects of its diagnosis and treatment.

A M Marques


The Left Main Disease (LMD) assumes a special particularity within the coronary pathology, because of its seriousness and of its urgent need of surgical treatment. The lesion is associated mainly with clinical situations of unstable angina, and who's diagnose by non-invasive methods is extremely difficult; among these methods the echocardiography and specially the stress test still remain of most value in this diagnosis. Coronary arteriography remains the standard exam and is indispensable for a positive confirmation of diagnosis. However, the risk involved here is significantly higher than in other coronary pathologies especially if the lesion of LMD is localized in the proximal region or is ostium level. Therefore, in this review, the need of special care is emphasized before, during and after catheterization, in patients with sunpect of LMD or in those in which the diagnosis was placed during the angiographic examination. Finally, it is very important to recognize the most dangerous situations in order to rightly identify those who need urgent surgical treatment.

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