Salvatore Lentini1 and Sossio Perrotta2
Posters-Accepted Abstracts: J Clin Exp Cardiolog
Pulmonary artery dissection (PAD) is a rare and often lethal event. It affects the main pulmonary artery in 80% of cases. It occurs mainly in patients with underlying chronic pulmonary hypertension leading to pulmonary artery aneurysm. It is often associated to congenital cardiac anomalies and often a patent ductus arteriosus is present. However, other causes include connective tissue disorders, right heart endocarditis, amyloidosis, trauma, and severe atherosclerosis. Usually, patients present with chest pain, dyspnoea and cyanosis, progressing rapidly to hemodynamic deterioration leading to sudden death due to rupture of the aneurysm. However, in rare cases, PAD may present with subtle non-specific symptoms. PAD is usually diagnosed during post-mortem examination and only very few cases have been previously treated surgically and reported in the literature. It is worth considering this rare condition during the differential diagnosis workup. An enlargement of the PA on the chest x-ray should raise the suspicion of a pulmonary artery aneurysm and call for further imaging studies. Echocardiography should represent the first line of investigation followed by computed CT-scan. This one would accurately evaluate the pulmonary artery anatomy with the aneurysm extension, the intimal flap, the presence of intraluminal thrombi and the presence of haemopericardium.