Fatal pulmonary arterial dissection and sudden death as initial manifestation of primary pulmonary hypertension

Arena, Vincenzo; De-Giorgio, Fabio; Abbate, Antonio; Capelli, Arnaldo; Mercurio, Domenico; Carbone, Arnaldo

doi:10.1016/j.carpath.2004.02.003

Cited by 25 publications

(18 citation statements)

References 7 publications

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“…Its pathogenesis and natural history remains poorly understood [5]. Despite several reports proposing that several underlying diseases are associated with the development of PA dissection, for instance, preexisting pulmonary artery aneurysm, degeneration associated with Marfan syndrome or cystic medionecrosis, and pulmonary hypertension, particularly in those with ductus arteriosus or congenital cardiovascular abnormalities [1][2][3][4][5][6]. In contrast, simultaneous dissection of the aorta and the PA is even rare with only one case reported [6].…”

Section: Discussionmentioning

confidence: 83%

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Acute concomitant pulmonary artery and aortic dissection with rupture

Hsu

Tzao

Tsai

et al. 2006

Int J Cardiovasc Imaging

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Pulmonary artery (PA) dissection is uncommon and may lead to rupture and sudden death if encountered. A 63-year-old man presented to our emergency room with episodic left chest pain radiating to the back followed by shortness of breath. A 64-row multidetector computed tomography (MDCT) revealed ruptured dissection of the PA and the aorta with hemopericardium, hemomediastinum, and prominent extravasated blood along the central bronchovascular bundles of both lungs. The patient experienced cardiogenic shock immediately following CT study and died after resuscitation. Concomitant PA and aortic dissection with rupture is extremely rare with the pathogenesis remaining investigated. MDCT proves to be a powerful tool in its diagnosis for a timely surgical repair if the patient could survive to have the operation.

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Section: Discussionmentioning

confidence: 83%

“…Once ruptured, it carries a high mortality [1][2][3][4][5]9]. In one review, a 73% (38 out of 52 cases) of rupture occurred in patients with PA dissection [2].…”

Section: Discussionmentioning

confidence: 97%

Acute concomitant pulmonary artery and aortic dissection with rupture

Hsu

Tzao

Tsai

et al. 2006

Int J Cardiovasc Imaging

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“…There have been case reports where this is the first presentation of chronically undiagnosed PH. 12 Symptoms are non-specific and range from chest pain to dyspnoea.…”

Section: Pulmonary Artery Dissectionmentioning

confidence: 99%

Complications of pulmonary hypertension: a pictorial review

Mak¹,

Strickland²,

Gopalan³

2017

The British Journal of Radiology

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Pulmonary hypertension (PH) is a rare disease with a significant morbidity and mortality if untreated. The disease has a multifactorial aetiology and is often associated with insidious onset of signs and symptoms. Multimodality imaging is often required for establishing the diagnosis, evaluating the underlying haemodynamic compromise and follow-up after institution of therapy. The range of potential complications associated with PH vary widely. We aimed to summarize the imaging findings of complications that the radiologist should be familiar with.

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“…67 In contrast to aortic dissection, the false lumen in PAD tend to rupture rather than to develop a re-entry site. 68 PAR may occur into the pericardium [70][71][72] or pleural cavity, leading to sudden death, and usually involves the site of maximal diameter of the pulmonary artery.…”

Section: Pulmonary Artery Dissection and Rupturementioning

confidence: 99%

“…The diagnosis of PAD and PAR is usually made postmortem, as the majority of these patients experience sudden death. 70 High suspicion is needed in a PAH patient presenting with acute dyspnea on exertion, retrosternal chest pain, central cyanosis, and sudden hemodynamic decompensation. 69 Symptom initiation may occur during exercise, as an acute increase in pulmonary arterial pressure, combined with the inflammatory substrate in PAH.…”

Section: Pulmonary Artery Dissection and Rupturementioning

confidence: 99%

Complications Leading to Sudden Cardiac Death in Pulmonary Arterial Hypertension

Demerouti

Manginas²,

Athanassopoulos

et al. 2012

Respir Care

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SummaryPulmonary arterial hypertension (PAH) is a disease of small pulmonary arteries, characterized by vascular proliferation and remodeling. Progressive increase in pulmonary vascular resistance ultimately leads to right ventricular heart failure and death. PAH-specific drug therapy has improved clinical outcomes and survival. While the survival is better, progression of pulmonary vasculopathy contributes to pulmonary artery dilatation. Left main compression syndrome, pulmonary artery dissection, pulmonary artery rupture, and severe hemoptysis are reported as complications leading to sudden cardiac death, an event encountered more often in PAH patients. The advent of PAHtargeted drug therapy has reduced referral for lung transplantation; however, severe complications require rapid diagnosis, decision making, and possible registration on a lung transplantation waiting list. PAH referral centers provide multidisciplinary emergency care and specific therapeutic management, contributing to improved quality of life and survival for PAH patients. We review the complications leading to sudden death in PAH. Key words: pulmonary hypertension; pulmonary artery dissection; pulmonary artery rupture; left main compression syndrome. [Respir Care 2013;58(7):1246 -1254.

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Fatal pulmonary arterial dissection and sudden death as initial manifestation of primary pulmonary hypertension

Cited by 25 publications

References 7 publications

Acute concomitant pulmonary artery and aortic dissection with rupture

Acute concomitant pulmonary artery and aortic dissection with rupture

Complications of pulmonary hypertension: a pictorial review

Complications Leading to Sudden Cardiac Death in Pulmonary Arterial Hypertension

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