Korean J Radiol.  2004 Jun;5(2):139-142. 10.3348/kjr.2004.5.2.139.

Aortic Dissection Presenting with Secondary Pulmonary Hypertension Caused by Compression of the Pulmonary Artery by Dissecting Hematoma: A Case Report

• Kim DH
• Ryu SW
• Choi YS
• Ahn BH

• KMID: 753995
• DOI: http://doi.org/10.3348/kjr.2004.5.2.139

Abstract

The rupture of an acute dissection of the ascending aorta into the space surrounding the pulmonary artery is an uncommon occurrence. No previous cases of transient pulmonary hypertension caused by a hematoma surrounding the pulmonary artery have been documented in the literature. Herein, we report a case of acute aortic dissection presenting as secondary pulmonary hypertension.

Keyword

Radiograph, aorta; Computed tomography (CT), aorta; Aorta, dissection; Dissection, pulmonary hypertension

MeSH Terms

Aortic Aneurysm/*complications/diagnosis
Aortic Rupture/*complications/diagnosis
Constriction, Pathologic
Female
Hematoma/*complications
Human
Hypertension, Pulmonary/*etiology
Middle Aged
Pulmonary Artery/pathology/radiography
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A 64-year-old woman with ascending aortic dissection presenting as secondary pulmonary hypertension. A. An admission chest radiograph shows cardiomegaly with tortuous thoracic aorta, patch infiltration in right lower lobe, and blunting in both costophrenic angles. Mediastinal widening is not definite. B. Preoperative transthoracic echocardiography shows an undulating intimal flap (arrow), dilated ascending aorta, and pericardial effusion (E). C. Preoperative chest CT demonstrates intimal flap (arrow) of ascending aortic dissection (DeBakey type 2), pericardial effusion, and bilateral pleural effusions. D. Chest CT image obtained 1.5 cm above C shows compression of the pulmonary artery by hematoma. Expanding dissection causes aneurysmal dilatation of ascending aorta (4 cm in diameter). E. Schematic drawing in craniocaudal view with cross section of the ascending aorta and pulmonary artery. Right and left pulmonary arteries (rPA & lPA) are severely compressed by the hematoma (H), but coronary ostia are intact. The tear point is E situated at the posterolateral wall (arrow) of the ascending aorta.

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