IMAGES IN THORAX
An unusual presentation of pulmonary artery dissection
1 Department of Cardiology, Leeds General Infirmary, Leeds, UK
2 Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics Health and Therapeutics, University of Leeds, UK
3 Department of Clinical Radiology, Leeds General Infirmary, Leeds, UK
Correspondence to:
Dr S L Hoye, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK; sarahhoye@hotmail.com
Accepted 3 September 2008
| The first 150 words of the full text of this article appear below. |
A morbidly obese woman presented with exertional dyspnoea and leg swelling. Past medical history included deep venous thrombosis and atrial fibrillation. Arterial blood gases demonstrated chronic respiratory acidosis and type 2 respiratory failure. Further evaluation consisted of spirometry (restrictive defect), Epworth scoring, overnight pulse oximetry (median oxygen saturation 68%) and echocardiography (pulmonary artery pressure 59 mm Hg). CT pulmonary angiography excluded signs of acute or chronic thromboembolism but demonstrated a 4 cm long dissection flap in the lower lobe segmental branch of the left pulmonary artery (fig 1).
Figure 1 (A–C) Volume rendered oblique coronal and axial images showing the relationship of the dissection flap (short arrows) to the left lower lobe pulmonary artery. The dissection commences immediately proximal to the lingular segmental artery branch (arrowhead, fig 1C). Ao, aorta; PA, pulmonary artery.
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DISCUSSION
This case is unique, representing chronic segmental pulmonary artery dissection secondary to cor pulmonale and pulmonary
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Thorax 2009 64: i.[Extract] [Full Text] [PDF]
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