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Case report
Central airway compression by massively dilated pulmonary artery in a patient with pulmonary arterial hypertension: a rare entity
  1. Biplab Kumar Saha and
  2. Scott Beegle
  1. Pulmonary and Critical Care Medicine, Albany Medical Center Hospital, Albany, New York, USA
  1. Correspondence to Dr Biplab Kumar Saha; spanophiliac{at}yahoo.com

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.

  • ischaemic heart disease
  • intensive care
  • radiology
  • pulmonary hypertension

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Footnotes

  • Contributors BKS and SB were involved in direct patient care. BKS planned, collected data and prepared the manuscript. SB supervised the preparation of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

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