Abstract
A 51-year-old woman with pulmonary arterial hypertension presented with progressive chest pain and dyspnea. Computed tomography imaging showed significant enlargement of her main pulmonary artery (PA) and was suggestive of left main coronary artery (LMCA) compression by the PA. The patient underwent percutaneous coronary intervention, which confirmed the diagnosis and a stent was deployed to the LMCA. Three months after the procedure the patient has near resolution of her symptoms. LMCA compression by an enlarged PA is an important cause of chest pain in patients with pulmonary arterial hypertension and can be managed safely and effectively with percutaneous coronary intervention and stenting.