Enhanced EP4 Expression in a Pulmonary Artery Aneurysm With Dissection in a Patient With Pulmonary Arterial Hypertension
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- computed tomography
- patent ductus arteriosus prostaglandins
- pulmonary artery
- pulmonary hypertension
Pulmonary artery (PA) aneurysm is sometimes found in patients with pulmonary arterial hypertension (PAH), and PA dissection is a rare but life-threatening complication. The pathological background of PA aneurysms and dissection remains poorly understood.
A 29-year-old man was diagnosed with PAH associated with patent ductus arteriosus (PDA; Movie I in the Data Supplement) and was in World Health Organization functional class II. Chest radiography showed an enlargement of the PA (Figure 1A). Contrast-enhanced computed tomography demonstrated large PA aneurysm with a diameter of 72 mm (Figure 1B). His PA pressure was 58/33 (44) mm Hg, and PA wedge pressure was 6 mm Hg. We closed the PDA with a coil. Seven years after the diagnosis, he was transported to our hospital with sudden chest pain and deteriorating consciousness. Systemic blood pressure was 92/63 mm Hg, heart rate was 83/min, and oxygen saturation was 98% with 3 L/min of oxygen administered. A chest radiography showed marked enlargement …