Unstable angina due to extrinsic coronary compression secondary to a giantic pulmonary artery aneurysm: An uncommon etiology

Pulmonary hypertension (PH) is characterized by remodeling of the pulmonary blood vessels, resulting in structural and functional changes. While dyspnea and angina are common symptoms associated with the disease, rarely do they might stem from atypical factors like compression of the coronary arteries. Hence, it is crucial to consider anatomical imaging studies when assessing these patients. Treatment decisions depend on several factors, including disease severity and concurrent medical conditions. In this case report, we present a patient with both PH and a sizable pulmonary artery (PAA), which significantly compressed the left main coronary artery (LMCA). Conservative management was pursued, leading to a successful outcome. The occurrence of angina due to PAA in PH patients, although rare, underscores the importance of conducting a comprehensive evaluation for an accurate diagnosis.