Complications of pulmonary artery aneurysms in pulmonary arterial hypertension. Issue 3 (3rd July 2018) - Rannelli, Luke A.
ABSTRACT: Pulmonary artery aneurysm (PAA) is a rare complication of pulmonary arterial hypertension (PAH), often occurring in patients with long-standing disease. Complications of PAA include pulmonary artery rupture, thrombosis, pulmonic valve regurgitation and coronary artery compression, which can result in myocardial ischemia. Diagnosis of coronary artery compression due to PAA is based on suggestive symptoms, imaging and coronary angiography. We present a case of a 70-year-old Caucasian female with longstanding vaso-reactive PAH complicated by a large PAA compressing the left anterior descending (LAD) coronary artery. The compressed LAD was not amenable to coronary stenting, however due to extensive coronary collateralization she was managed medically with dual antiplatelet therapy and cardiovascular risk reduction, with improvement in symptoms and stability for over 2 years.