BMJ Case Reports 2017; doi:10.1136/bcr-2016-218885
  • Rare disease

Paediatric case of ductal origin of right pulmonary artery presenting with exertional dyspnoea and mimicking asthma and primary ciliary dyskinesia

  1. Athar M Qureshi4
  1. 1Department of Pediatrics, Mc Lane Children’s Hospital. Baylor Scott and White Health, Temple, Texas, USA
  2. 2Department of Internal Medicine/Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
  3. 3Department of Pediatrics, Baylor College of Medicine, San Antonio, Texas, USA
  4. 4Department of Cardiology, Texas Children’s Hospital, Houston, Texas, USA
  1. Correspondence to Dr Malvika Sagar MD, malvika.sagar{at}
  • Accepted 26 September 2017
  • Published 10 October 2017


Ductal origin of pulmonary artery is a rare anomaly that is frequently misdiagnosed. Patients may present with exertional dyspnoea, recurrent respiratory infections and pulmonary hypertension. The presence of pulmonary hypertension can adversely affect clinical outcome in these patients; hence, early identification and intervention is the key to improve survival. A case of a 3-year-old child presenting with exertional dyspnoea is presented in this report. Chest radiograph revealed right-sided pulmonary hypoplasia and mediastinal shift to the right. Pulmonary artery agenesis was suspected when CT of the chest demonstrated right-sided pulmonary artery agenesis. Cardiac catheterisation revealed the correct diagnosis of ductal origin of right pulmonary artery. The most striking feature of this case is that the clinical presentation is mild compared with the findings on imaging.


  • Contributors MS conceptualised the presentation, collected the data, drafted the manuscript, reviewed and revised the data critically for important intellectual content, and approved the final manuscript as submitted. ASM and CWC collected the data, drafted part and some of the initial manuscript, revised the manuscript and approved the final manuscript as submitted. AMQ drafted and edited some of the manuscript, provided figures and approved the final manuscript as submitted.

  • Competing interests None declared.

  • Patient consent Guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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