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Published in: Journal of Medical Case Reports 1/2009

Open Access 01-12-2009 | Case report

Idiopathic pulmonary artery dissection: a case report

Authors: Khalid Mohammad, Mohammad Sahlol, Osbert Egiebor, Ruxana T Sadikot

Published in: Journal of Medical Case Reports | Issue 1/2009

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Abstract

Introduction

The occurrence of pulmonary artery dissection is extremely rare in patients without pulmonary hypertension, congenital cardiac abnormalities or cardiac intervention. A diagnosis of pulmonary artery dissection is rarely made during life because it generally leads to cardiogenic shock and sudden death. The progression or natural course of pulmonary artery dissection is not known and the optimum management is not defined because of the paucity of cases in the literature.

Case presentation

We report a rare case of a 51-year-old female patient, without pulmonary hypertension or other cardiac abnormalities, who presented with acute chest pain and was found to have a pulmonary artery dissection.. The diagnosis of pulmonary artery dissection was confirmed by computed tomography scan of the chest and cardiac magnetic resonance imaging. The patient declined surgical intervention and was followed up closely with medical therapy. At almost a year after her initial presentation, the patient is stable with no complications.

Conclusions

To our knowledge, there are no similar cases reported in the literature of people with pulmonary artery dissection who have been followed up and who have not had surgical intervention. We review the etiology, pathophysiology, clinical associations, diagnosis and management of patients with pulmonary artery dissection.
Literature
1.
go back to reference Shilkin KB, Low LP, Chen BTM: Dissecting aneurysm of the pulmonary artery. J Pathol. 1969, 98: 25-29. 10.1002/path.1710980104.CrossRefPubMed Shilkin KB, Low LP, Chen BTM: Dissecting aneurysm of the pulmonary artery. J Pathol. 1969, 98: 25-29. 10.1002/path.1710980104.CrossRefPubMed
2.
go back to reference Luchtrath H: Dissecting aneurysm of the pulmonary artery. Virchows Arch (Pathol Anat). 1981, 391: 241-247. 10.1007/BF00437600.CrossRef Luchtrath H: Dissecting aneurysm of the pulmonary artery. Virchows Arch (Pathol Anat). 1981, 391: 241-247. 10.1007/BF00437600.CrossRef
3.
go back to reference Yamamoto ME, Jones JW, McManus BM: Fatal dissection of the pulmonary trunk: an obscure consequence of chronic pulmonary hypertension. Am J Cardiovasc Pathol. 1988, 1: 353-359.PubMed Yamamoto ME, Jones JW, McManus BM: Fatal dissection of the pulmonary trunk: an obscure consequence of chronic pulmonary hypertension. Am J Cardiovasc Pathol. 1988, 1: 353-359.PubMed
4.
go back to reference Walley VM, Virmani R, Silver MD: Pulmonary arterial dissections and ruptures: to be considered in patients with pulmonary arterial hypertension presenting with cardiogenic shock or sudden death. Pathology. 1990, 22: 1-4. 10.3109/00313029009061416.CrossRefPubMed Walley VM, Virmani R, Silver MD: Pulmonary arterial dissections and ruptures: to be considered in patients with pulmonary arterial hypertension presenting with cardiogenic shock or sudden death. Pathology. 1990, 22: 1-4. 10.3109/00313029009061416.CrossRefPubMed
5.
go back to reference Andrews R, Colloby P, Hubner PJB: Pulmonary artery dissection in a patient with idiopathic dilatation of the pulmonary artery: a rare cause of sudden death. Br Heart J. 1993, 69: 268-269. 10.1136/hrt.69.3.268.CrossRefPubMedPubMedCentral Andrews R, Colloby P, Hubner PJB: Pulmonary artery dissection in a patient with idiopathic dilatation of the pulmonary artery: a rare cause of sudden death. Br Heart J. 1993, 69: 268-269. 10.1136/hrt.69.3.268.CrossRefPubMedPubMedCentral
6.
go back to reference Green NJ, Rollason TP: Pulmonary artery rupture in pregnancy complicating patent ductus arteriosus. Br Heart J. 1992, 68: 616-618. 10.1136/hrt.68.12.616.CrossRefPubMedPubMedCentral Green NJ, Rollason TP: Pulmonary artery rupture in pregnancy complicating patent ductus arteriosus. Br Heart J. 1992, 68: 616-618. 10.1136/hrt.68.12.616.CrossRefPubMedPubMedCentral
7.
go back to reference Masuda S, Ishii T, Asuwa N: Concurrent pulmonary arterial dissection and saccular aneurysm associated with primary pulmonary hypertension. Arch Pathol Lab Med. 1996, 120: 309-312.PubMed Masuda S, Ishii T, Asuwa N: Concurrent pulmonary arterial dissection and saccular aneurysm associated with primary pulmonary hypertension. Arch Pathol Lab Med. 1996, 120: 309-312.PubMed
8.
go back to reference Thierrien J, Gerlis LM, Kilner P: Complex pulmonary atresia in an adult: natural history, unusual pathology and mode of death. Cardiol Young. 1999, 9: 249-256. 10.1017/S104795110000490X.CrossRefPubMed Thierrien J, Gerlis LM, Kilner P: Complex pulmonary atresia in an adult: natural history, unusual pathology and mode of death. Cardiol Young. 1999, 9: 249-256. 10.1017/S104795110000490X.CrossRefPubMed
9.
go back to reference Rosenson RS, Sutton MSJ: Dissecting aneurysm of the pulmonary artery trunk in mitral stenosis. Am J Cardiol. 1986, 58: 1140-1141. 10.1016/0002-9149(86)90142-6.CrossRefPubMed Rosenson RS, Sutton MSJ: Dissecting aneurysm of the pulmonary artery trunk in mitral stenosis. Am J Cardiol. 1986, 58: 1140-1141. 10.1016/0002-9149(86)90142-6.CrossRefPubMed
10.
go back to reference Steurer J, Jenni R, Medici TC: Dissecting aneurysm of the pulmonary artery with pulmonary hypertension. Am Rev Respir Dis. 1990, 142: 1219-1221.CrossRefPubMed Steurer J, Jenni R, Medici TC: Dissecting aneurysm of the pulmonary artery with pulmonary hypertension. Am Rev Respir Dis. 1990, 142: 1219-1221.CrossRefPubMed
11.
go back to reference Sakamaki Y, Minami M, Ohta M, Takahashi T, Matsumiya G, Miyoshi S, Matsuda H: Pulmonary artery dissection complicating lung transplantation for primary pulmonary hypertension. Ann Thorac Surg. 2006, 81: 360-362. 10.1016/j.athoracsur.2004.08.041.CrossRefPubMed Sakamaki Y, Minami M, Ohta M, Takahashi T, Matsumiya G, Miyoshi S, Matsuda H: Pulmonary artery dissection complicating lung transplantation for primary pulmonary hypertension. Ann Thorac Surg. 2006, 81: 360-362. 10.1016/j.athoracsur.2004.08.041.CrossRefPubMed
12.
go back to reference Wuyts WA, Herijgers P, Budts W, De Wever W, Delcroix M: Extensive dissection of the pulmonary artery treated with combined heart-lung transplantation. J Thorac Cardiovasc Surg. 2006, 132: 205-206. 10.1016/j.jtcvs.2006.03.037.CrossRefPubMed Wuyts WA, Herijgers P, Budts W, De Wever W, Delcroix M: Extensive dissection of the pulmonary artery treated with combined heart-lung transplantation. J Thorac Cardiovasc Surg. 2006, 132: 205-206. 10.1016/j.jtcvs.2006.03.037.CrossRefPubMed
13.
go back to reference Lopez-Candales A, Kleiger RE, Aleman-Gomez J: Pulmonary artery aneurysm: review and case report. Clin Cardiol. 1995, 18: 738-740. 10.1002/clc.4960181211.CrossRefPubMed Lopez-Candales A, Kleiger RE, Aleman-Gomez J: Pulmonary artery aneurysm: review and case report. Clin Cardiol. 1995, 18: 738-740. 10.1002/clc.4960181211.CrossRefPubMed
14.
go back to reference Wunderbaldinger P, Bernhard C, Uffmann M: Acute pulmonary trunk dissection in a patient with primary pulmonary hypertension. J Comput Assist Tomogr. 2000, 24: 92-95. 10.1097/00004728-200001000-00019.CrossRefPubMed Wunderbaldinger P, Bernhard C, Uffmann M: Acute pulmonary trunk dissection in a patient with primary pulmonary hypertension. J Comput Assist Tomogr. 2000, 24: 92-95. 10.1097/00004728-200001000-00019.CrossRefPubMed
15.
go back to reference Inayama Y, Nakatani Y, Kitamura H: Pulmonary artery dissection in patients without underlying pulmonary hypertension. Histopathology. 2001, 38: 435-442. 10.1046/j.1365-2559.2001.01129.x.CrossRefPubMed Inayama Y, Nakatani Y, Kitamura H: Pulmonary artery dissection in patients without underlying pulmonary hypertension. Histopathology. 2001, 38: 435-442. 10.1046/j.1365-2559.2001.01129.x.CrossRefPubMed
16.
go back to reference Senbaklavaci O, Kaneko Y, Bartunek A: Rupture and dissection in pulmonary artery aneurysms: incidence, cause and treatment - review and case report. J Thorac Cardiovasc Surg. 2001, 121: 1006-1008. 10.1067/mtc.2001.112634.CrossRefPubMed Senbaklavaci O, Kaneko Y, Bartunek A: Rupture and dissection in pulmonary artery aneurysms: incidence, cause and treatment - review and case report. J Thorac Cardiovasc Surg. 2001, 121: 1006-1008. 10.1067/mtc.2001.112634.CrossRefPubMed
17.
go back to reference Song EK, Kolecki P: A case of pulmonary artery dissection diagnosed in the emergency department. J Emerg Med. 2002, 23: 155-159. 10.1016/S0736-4679(02)00503-6.CrossRefPubMed Song EK, Kolecki P: A case of pulmonary artery dissection diagnosed in the emergency department. J Emerg Med. 2002, 23: 155-159. 10.1016/S0736-4679(02)00503-6.CrossRefPubMed
18.
go back to reference Khatchatourian G, Vala D: Images in cardiovascular medicine Acute type I aortic dissection with concomitant pulmonary artery dissection. Circulation. 2005, 112: e313-e314.PubMed Khatchatourian G, Vala D: Images in cardiovascular medicine Acute type I aortic dissection with concomitant pulmonary artery dissection. Circulation. 2005, 112: e313-e314.PubMed
19.
go back to reference Hsu HH, Tzao C, Tsai CS, Sun GH, Chen CY: Acute concomitant pulmonary artery and aortic dissection with rupture. Int J Cardiovasc Imaging. 2007, 23: 411-414. 10.1007/s10554-006-9160-1.CrossRefPubMed Hsu HH, Tzao C, Tsai CS, Sun GH, Chen CY: Acute concomitant pulmonary artery and aortic dissection with rupture. Int J Cardiovasc Imaging. 2007, 23: 411-414. 10.1007/s10554-006-9160-1.CrossRefPubMed
20.
go back to reference Navas Lobato MA, Martín Reyes R, Lurueña Lobo P, Maté Benito I, Guzmán Hernández G, Martí de Gracia M, Sobrino Daza JA, López Sendón JL: Pulmonary artery dissection and conservative medical management. Int J Cardiol. 2007, 119: e25-e26. 10.1016/j.ijcard.2007.01.088.CrossRefPubMed Navas Lobato MA, Martín Reyes R, Lurueña Lobo P, Maté Benito I, Guzmán Hernández G, Martí de Gracia M, Sobrino Daza JA, López Sendón JL: Pulmonary artery dissection and conservative medical management. Int J Cardiol. 2007, 119: e25-e26. 10.1016/j.ijcard.2007.01.088.CrossRefPubMed
Metadata
Title
Idiopathic pulmonary artery dissection: a case report
Authors
Khalid Mohammad
Mohammad Sahlol
Osbert Egiebor
Ruxana T Sadikot
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2009
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.4076/1752-1947-3-7426

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