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Pulmonary Artery Aneurysm


Presentation

  • CONCLUSIONS: LMCA stenting appears to be a feasible and durable option in patients who present with angina because of compression by PAA.[ncbi.nlm.nih.gov]
  • Abstract Pulmonary artery aneurysm presenting with dissection and hemopericardium is extremely rare, and we came across one such case in our center. The patient was a 22-year-old man who presented with dyspnoea, tachypnoea, and pallor.[ncbi.nlm.nih.gov]
  • We present the case of a 60-year-old female with pulmonary artery aneurysm (PAA) associated with an atrial septal defect and pulmonary arterial hypertension. There is no standard therapeutic approach for PAA at the present time.[ncbi.nlm.nih.gov]
  • This case is reported for its unsuspected presentation and rarity and to highlight the use of catheter coil embolization to achieve endovascular exclusion of the aneurysm from pulmonary circulation.[ncbi.nlm.nih.gov]
  • BD is a multisystem disorder presenting with recurrent oral and genital ulcerations, as well as ocular involvement, and PAA is one of its rare complications.[ncbi.nlm.nih.gov]
Asymptomatic
  • Idiopathic PAA is generally asymptomatic and has an increased risk for dissection or rupture of the aneurysm.[ncbi.nlm.nih.gov]
  • Author information 1 Department of Cardiac Surgery, Landesklinikum Sankt Pölten, Austria. [email protected] Abstract A 60-year-old male being treated for chronic venous stasis ulcers presented with an asymptomatic pulmonary artery aneurysm[ncbi.nlm.nih.gov]
  • Postoperatively, the patient remained asymptomatic with trivial pulmonary regurgitation 1 year later. To our knowledge, this is the first report of a pentacuspid pulmonary valve repair. Copyright 2016 The Society of Thoracic Surgeons.[ncbi.nlm.nih.gov]
  • Due to the patient's clinical history (asymptomatic, located in the pulmonary trunk, with no data indicating a high risk of rupture), it was decided to opt for a conservative approach to the aneurysm.[archbronconeumol.org]
  • It can be asymptomatic, being a chance finding in a chest x-ray as in our patient.[revespcardiol.org]
Pathologist
  • This enabled the pathologist to locate the exact rupture site that caused the hemopericardium.[ncbi.nlm.nih.gov]
Fishing
  • This is the first 22qDS case with PAA that was detected prenatally by FISH analysis.[ncbi.nlm.nih.gov]
Hemoptysis
  • Intravenous administration of antibiotics and thoracic drainage successfully controlled the infection and inflammation until day 16, when the patient began to exhibit hemoptysis and bloody pleural effusion.[ncbi.nlm.nih.gov]
  • Hemoptysis of pulmonary arterial origin is also infrequent; however, the mortality is as high as 50%.[ncbi.nlm.nih.gov]
  • Abstract A 42-year-old male presented with recurrent hemoptysis owing to a leaking peripheral pulmonary artery aneurysm. He was treated with selective coil embolization of the right posterior basal segmental artery to achieve hemostasis.[ncbi.nlm.nih.gov]
  • We present the case of a 35-year-old male patient with dyspnea and hemoptysis in whom subsequent imaging studies revealed a giant pulmonary artery aneurysm associated with an uncorrected patent ductus arteriosus and Eisenmenger's syndrome.[ncbi.nlm.nih.gov]
  • Hemoptysis ceased for 4 months, and then he experienced three episodes of massive hemoptysis in one week. Emergency right pneumonectomy had to be performed.[atm.amegroups.com]
Cough
  • CASE REPORT: This male patient was admitted with a month-long history of progressive shortness of breath, 2-month history of fever, and a cough with mucoid sputum for 10 days.[ncbi.nlm.nih.gov]
  • Abstract Idiopathic pulmonary artery aneurysm rupture was diagnosed in a 79-year-old man who presented with a dry cough.[ncbi.nlm.nih.gov]
  • Progressive increase of dilatation may lead to cough, as in our case. Georg Thieme Verlag KG Stuttgart · New York.[ncbi.nlm.nih.gov]
  • Comment According to the descriptive card, the patient was a 21 year-old man who died “from exhaustion” following hemoptysis (coughing up blood). (Additional details given by Osler in his autopsy protocol 710 are lost).[mcgill.ca]
  • Full Text We present the case of a 77-year-old patient with a history of hypertension and glaucoma, who was admitted to our hospital for symptoms of dyspnea at rest, with no cough or expectoration.[archbronconeumol.org]
Dry Cough
  • Abstract Idiopathic pulmonary artery aneurysm rupture was diagnosed in a 79-year-old man who presented with a dry cough.[ncbi.nlm.nih.gov]
  • The patient reported the onset of dry cough, weight loss, fever, hyporexia, adynamia and some episodes of hemoptysis for two months. Later, he presented progressive dyspnea.[rb.org.br]
Chest Pain
  • Abstract We report a pulmonary artery (PA) aneurysm associated with severe aortic stenosis and an aortic root dilatation occurring in a 59-year-old woman who presented with dyspnoea and chest pain.[ncbi.nlm.nih.gov]
  • After successful LMCA stent implantation, chest pain was greatly relieved.[ncbi.nlm.nih.gov]
  • However, surgical treatment is required in cases of right ventricular dysfunction, severe valvular insufficiency, and symptomatic patients with chest pain, shortness of breath, coughing, and hemoptysis, as an aneurysm of 6 cm has an increased risk of[tgkdc.dergisi.org]
  • Full Text A 47-year-old man with no medical history presented to the emergency department complaining of severe sharp chest pain 3 h lasting, exacerbated with deep inspiration and accompanied by increasing dyspnea.[elsevier.es]
  • In symptomatic patients, dyspnea, hemoptysis and chest pain are most frequent. 1,3 Hemoptysis generally indicates instability of the aneurysm and indicates the need for surgical intervention.[revespcardiol.org]
Vascular Disease
  • You are more likely to have vascular disease as you get older.[icdlist.com]
  • VASCULAR DISEASE MANAGEMENT 2015;12(12):E242-E246 Key words: pesudoaneurysm, endovascular therapy _____________________________________________________ Pulmonary artery aneurysms and pseudoaneurysms are uncommon and can be a serious cause of morbidity[vasculardiseasemanagement.com]
Systolic Murmur
  • Her physical examination showed that she was hemodynamically stable, with an increased breath rate of 22 breaths/minute and a left parasternal systolic murmur.[jmedicalcasereports.biomedcentral.com]

Workup

Right Ventricular Hypertrophy
  • Transthoracic echocardiogram showed dilatation of the right atrium and right ventricle, with right ventricular hypertrophy. There was severe pulmonary valve regurgitation, and the main pulmonary artery was dilated to 68 mm in diameter.[ncbi.nlm.nih.gov]

Treatment

  • Due to a positive vasoreactivity test, treatment with calcium channel blockers was started with near normalization of the right cardiac pressures.[ncbi.nlm.nih.gov]
  • Careful treatment should be considered because of the possibility of fatal complications including rupture, dissection, pulmonary embolism and heart failure. Our goal is to contribute a better understanding of this disease and its treatment.[ncbi.nlm.nih.gov]
  • Abstract Idiopathic pulmonary artery aneurysms are rare and need a multidisciplinary approach to diagnosis and treatment.[ncbi.nlm.nih.gov]
  • Pulmonary artery aneurysm is a rare pathology and the optimal treatment approach remains unclear in the absence of clear guidelines. We report a case of pulmonary aneurysm and discuss the treatment options. Copyright Acta Chirurgica Belgica.[ncbi.nlm.nih.gov]
  • A review of the literature in regards to incidence, etiology, clinical manifestations and treatment options is included. Copyright (c) 2009 Elsevier Ltd. All rights reserved.[ncbi.nlm.nih.gov]

Prognosis

  • We also discuss the natural history, prognosis and management of PA aneurysms.[ncbi.nlm.nih.gov]
  • Pulmonary vascular problems such as pulmonary artery aneurysms (PAA) are reported to indicate poor prognosis and high mortality. We describe a 43-year-old man who presented with life threatening bilateral PAA and thromboembolic disease due to BD.[ncbi.nlm.nih.gov]
  • In this report the causes of that rare lesion and the prognosis of pneumonectomy in infancy are reviewed. Received October 23, 1978. Accepted May 29, 1979.[pediatrics.aappublications.org]
  • The age of onset in our patient is higher than the 25 years associated with poor prognosis, however, the gender as well as the evidence of pulmonary artery aneurysm has been associated with high mortality and morbidity [1].[medcraveonline.com]
  • Pulmonary artery aneurysm (PAA) is the most lethal complication of the disease and suggests a poor prognosis. The mean survival after the onset of hemoptysis was reported to be about 10 months ( 1 ).[atm.amegroups.com]

Etiology

  • A review of the literature in regards to incidence, etiology, clinical manifestations and treatment options is included. Copyright (c) 2009 Elsevier Ltd. All rights reserved.[ncbi.nlm.nih.gov]
  • Abstract An idiopathic pulmonary artery aneurysm (PAA) is an uncommon lesion, and is defined when the diameter of the pulmonary trunk is greater than 30 mm in the absence of cardiac or pulmonary etiologies.[ncbi.nlm.nih.gov]
  • Common acquired etiologies include chronic thromboembolic pulmonary hypertension, infections (syphilis and tuberculosis), vasculitis (Behcet's and Hughes-Stovin syndromes), neoplasms (primaryandmetastatic), andtrauma(most often iatrogenic).[ncbi.nlm.nih.gov]
  • KEYWORDS: Angina pectoris/etiology; coronary vessel anomalies/complications; heart defects, congenital/complications/diagnosis/radiography; heart valves/abnormalities; pulmonary artery/abnormalities/pathology/surgery; treatment outcome[ncbi.nlm.nih.gov]
  • BACKGROUND: Extrinsic compression of the left main coronary artery (LMCA) by a pulmonary artery aneurysm (PAA) has become increasingly recognized as an etiology of angina in patients with pulmonary arterial hypertension (PAH).[ncbi.nlm.nih.gov]

Pathophysiology

  • Discussion A structural collagen tissue disorder or infection, thinning/weakening of the pulmonary artery wall due to chronic inflammation, wall tension created by degeneration, and chronic pressure/volume overload have been suggested to create the basic pathophysiological[tgkdc.dergisi.org]
  • […] aneurysms. 4 Low-pressure aneurysms seem to have a better prognosis than hypertensive aneurysms. 4 Chronic pulmonary embolism is a relatively common cause of PAAs, 3 such aneurysms present mural thickening, webs, and intramural thrombi that can calcify. 1 Pathophysiological[elsevier.es]
  • Increased PA pressure is common and natural pathophysiology in severe mitral stenosis but aneurysmal dilatation is very rare. Here we present a case with giant pulmonary artery aneurysm which was diagnosed intra-operatively.[casereports.in]
  • In the second patient, pulmonary valve stenosis and post-stenotic dilation could have been the pathophysiological basis of PAA development [ 11 ].[jmedicalcasereports.biomedcentral.com]

Prevention

  • We performed a novel surgical repair of a 67-mm PAA consisting of internal plication of the pulmonary artery to reduce the diameter and approximation of remnant unfolding pulmonary artery to reinforce the stability of the pulmonary artery and prevent[ncbi.nlm.nih.gov]
  • Despite the patient receiving medical therapy to treat recurrent pneumonia, lobectomy was necessary to prevent this and other possible complications.[ncbi.nlm.nih.gov]
  • Surgical approach should prevent aneurysm rupture, but it is not known when surgery should be preferred to strict medical follow-up.[ncbi.nlm.nih.gov]
  • Although medical therapy for pulmonary hypertension was started, surgical correction of the aneurysm was executed in order to prevent its future complications.[ncbi.nlm.nih.gov]
  • Timely involvement of interventional radiologists and thoracic surgeons prevented a potentiallylife-threatenninghemorrhage.[ncbi.nlm.nih.gov]

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