Giant pulmonary artery aneurysm due to pulmonary stenosis
- PDF / 321,612 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 32 Downloads / 196 Views
IMAGES IN CARDIOVASCULAR ULTRASOUND
Giant pulmonary artery aneurysm due to pulmonary stenosis Ozcan Basaran • Nesrin Filiz Basaran Mehmet Deveer
•
Received: 8 January 2013 / Revised: 5 February 2013 / Accepted: 28 February 2013 Ó Japanese Society of Echocardiography 2013
A 65-year-old woman was admitted to our institution with dyspnea on minor exercise. She had marked limitation on physical activity. Physical examination revealed grade 3/6 systolic murmur at the upper left sternal border. Her blood pressure was 130/80 mmHg and her pulse was irregular at a 75 bpm. She had been diagnosed with hypertension and chronic obstructive pulmonary disease. Chest X-ray imaing showed pleural effusion, cardiomegaly, and dilatation of the pulmonary artery (Fig. 1). Pulmonary artery aneurysm was detected on transthoracic echocardiography (Fig. 2a and video 1 in the Supplementary Material). This pulmonary aneurysm was determined to be 62 mm (left main pulmonary artery 42 mm, right main pulmonary artery 25 mm) by thorax computed tomography (Fig. 2b). On color and continuous-wave Doppler analysis, pulmonary stenosis with a 102 mmHg peak and 62 mmHg mean gradient was shown (Fig. 2c, d and video 2 in the Supplementary Material). As the patient was symptomatic, she was referred to surgery but she refused operation. The etiology of pulmonary artery aneurysm has a number of differential diagnoses, which can be listed as
follows: pulmonary stenosis, pulmonary hypertension, congenital heart disease, Behc¸et’s disease, infections, arteriovenous fistulas, connective tissue diseases, atherosclerosis, and trauma. In the absence of these diagnoses, simple dilatation of the pulmonary trunk was described as idiopathic pulmonary artery aneurysm [1]. The etiology of idiopathic pulmonary artery aneurysm was poorly understood. Congenital weakness of the arterial wall was proposed as the underlying reason. Generally, poststenotic dilatation of the pulmonary artery is diffuse and involves its left branch [2]. As a result of the sharp angle in the origin of the right pulmonary artery, the high-velocity flow jet directly hits the left pulmonary artery wall. Asymmetrically elevated wall shear stress was thought
Electronic supplementary material The online version of this article (doi:10.1007/s12574-013-0171-3) contains supplementary material, which is available to authorized users. O. Basaran (&) Cardiology Clinic, Mugla University Education and Research Hospital, Orhaniye Mahallesi I˙smet C¸atak Caddesi, Mugla, Turkey e-mail: [email protected] N. F. Basaran Department of Pharmacology, Mugla University Medical Faculty, Mugla, Turkey M. Deveer Department of Radiology, Mugla University Medical Faculty, Mugla, Turkey
Fig. 1 Chest X-ray imaging showing pleural effusion (asterisks) and dilatation of the pulmonary artery (arrows)
123
J Echocardiogr
Fig. 2 a Transthoracic echocardiography showing a pulmonary artery aneurysm. b Thorax computed tomography showing a pulmonary artery aneurysm. c Color Doppler echocardiography
demonstrating poststeno
Data Loading...
