Fibrosing mediastinitis causing acute ostial left main myocardial infarction

Abstract

This report describes an unusual etiology of acute coronary syndrome. A 48-year-old female presented with anginal chest discomfort and was found to have evidence of acute pulmonary edema requiring mechanical ventilation. She underwent emergency coronary angiography and stenting of the culprit left-main artery ostial discrete stenosis. Subsequent echocardiography and magnetic resonance imaging revealed severe aortic regurgitation and periaortic valve tissue infiltrates. Pericardiectomy and mediastinal mass biopsy were performed which indicated the pathology of fibrosing mediastinitis.