Central airway compression by massively dilated pulmonary artery in a patient with pulmonary arterial hypertension: a rare entity. Issue 11 (25th November 2019)

• Record Type: Journal Article
• Authors: Saha, Biplab Kumar; Beegle, Scott
• Is Part Of: BMJ case reports. Volume 12:Issue 11(2019)
• Publication Date: 2019-11-25
• Subjects: ischaemic heart disease -- intensive care -- radiology -- pulmonary hypertension; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-232468
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Patients with pulmonary arterial hypertension (PAH) usually die from progressive right ventricular failure. Mechanical complications due to pulmonary artery (PA) enlargement are rare and include tracheobronchial and left main coronary artery compression, and PA dissection. A 62-year-old female with PAH was seen in our office for follow-up. During the evaluation, spirometry was performed, which revealed a severe obstructive ventilatory limitation. Subsequent workup identified compression of bilateral mainstem bronchi from the dilated PA as the aetiology for the abnormal spirometry. Very few cases of this rare complication have been reported in the literature. A significant dilation of the PA is necessary (>4 cm) for the occurrence of these complications. Dilation of PA is an independent risk factor for sudden unexpected death in patients with PAH.