Precision Care in Isolated Ostial Left Main Coronary Artery Disease: A Guided Approach


  • Zain Mehmood Butt Chaudhary Pervaiz Elahi Institute of Cardiology, Wazirabad-Pakistan.
  • Naveed Iqbal Chaudhary Pervaiz Elahi Institute of Cardiology, Wazirabad-Pakistan.
  • Shehzad Tawwab Chaudhary Pervaiz Elahi Institute of Cardiology, Wazirabad-Pakistan.


Introduction: Introduction: Isolated ostial left main coronary artery (LMCA) disease, a rare condition more prevalent in middle-aged females, presents unique diagnostic and therapeutic challenges. This case report highlights the importance of early diagnosis and tailored interventions for effective management. 

Case Presentation: A 45-year-old female with hypertension presented via the emergency room with typical ischemic chest pain. Elevated troponin levels, generalized ST-T depressions on ECG, and isolated critical ostial disease of the left main stem on angiography were evident. Clinical history, symptoms, and angiographic findings were notable.  

Results: Due to high TIMI risk score, early catheterization was pursued. Utilizing a "hit and run" strategy, a preloaded Balloon on guide wire within guider before engagement and rapid balloon inflations were employed to minimize ischemic complications. Post-stenting, non-selective guide engagement was employed to prevent stent deformation. The patient's post-procedure course was uneventful, and she was discharged in stable condition with guideline-directed therapy. One-year follow-ups showed medication adherence and good clinical progress.

Conclusion: Isolated LMCA ostial disease, though rare, presents substantial diagnostic and therapeutic complexities. Timely diagnosis and customized interventions are paramount for effective management. The case underscores considering this condition in specific patient groups, excluding coronary artery spasm, using controlled contrast injections, applying the "hit and run" technique, and utilizing available imaging. The core lesson is that a personalized approach enhances outcomes and prognosis in this infrequent ailment.


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How to Cite

Butt, Z. M., Iqbal , N., & Tawwab, S. (2023). Precision Care in Isolated Ostial Left Main Coronary Artery Disease: A Guided Approach. Cathalogue, 1(1), 25–32. Retrieved from