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Cardiothoracic Surgery |

Traumatic Pulmonary Artery Dissection: A Case Report

Atilla Can, MD; Hidir Esme, MD; Mustafa Calik, MD; Saniye Calik, MD
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Konya Education and Research Hospital, Konya, Turkey


Chest. 2015;148(4_MeetingAbstracts):28A. doi:10.1378/chest.2278213
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Abstract

SESSION TITLE: Cardiothoracic Surgery Global Case Reports

SESSION TYPE: Global Case Report Poster

PRESENTED ON: Tuesday, October 27, 2015 at 01:30 PM - 02:30 PM

INTRODUCTION: Pulmonary artery dissection is a rare condition which usually occurs in patients with underlying pulmonary arterial hypertension. The condition generally manifests as cardiogenic shock or sudden death because the dissection progresses rapidly and thereby it is usually diagnosed at post-mortem studies[1].We report a case of pulmonary artery dissection developing secondary to trauma.

CASE PRESENTATION: 42-year-old man was admitted with the left chest pain through cause of high falling. On the x-ray, the left hilar enlargement was detected and then contrast-enhanced thoracic CT imaging was performed. Hilar enlargement causing the image was found to be the dilated pulmonary artery. Left lower lobe pulmonary artery dissection revealed. In the echocardiographic evaluation second degree tricuspid insufficiency was detected and pulmonary artery pressure was measured 100 mmHg. Examination in terms of Behcet's disease has resulted in negative and there was also no history of syphilis in the history of the patient. General condition of the patient was well and had no symptoms so conservative approach has been done.

DISCUSSION: Pulmonary artery dissection is an extremely rare and fatal disease which is usually diagnosed on post-mortem examination. It usually occurs as a complication of chronic pulmonary arterial hypertension. Other rare causes include chronic inflammation of the pulmonary arteries, right heart endocarditis, amyloidosis, trauma and severe atherosclerosis [2].Pulmonary artery dissections usually occur in patients with medial degeneration and pulmonary arterial dilatation due to chronic increases in pulmonary arterial pressures [3-4].

CONCLUSIONS: In our case, there was pulmonary hypertension and we believe that trauma caused the pulmonary artery dissection. This condition is extremely rare in the literature.

Reference #1: Türkvatan, Aysel, et al. "Pulmonary Artery Dissection Diagnosed by Multidetector Computed Tomographic Angiography: Case Report." Turkiye Klinikleri Cardiovascular Sciences 21.2 (2009): 292-296.

Reference #2: Bhatia, Vikas, et al. "Role of Multi-Detector Computed Tomography (MDCT) in Diagnosis of Pulmonary Artery Dissection: A Rare but Fatal Entity." Annals of the Academy of Medicine, Singapore 43.1 (2014): 64

Reference #3: Inayama Y, Nakatani Y, Kitamura H. Pulmonary artery dissection in patients without underlying pulmonary hypertension. Histopathology 2001; 38: 435-442

DISCLOSURE: The following authors have nothing to disclose: Atilla Can, Hidir Esme, Mustafa Calik, Saniye Calik

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