Pulmonary artery aneurysm secondary to congenital pulmonic valve stenosis
Pulmonary artery (PA) aneurysms are uncommon and often diagnosed post-mortem. They
are characterized by a PA/aorta diameter ratio greater than 2 on transthoracic echocardiography
or a pulmonary artery diameter greater than 4 or 5 cm on computed tomography. The most
common conditions associated with pulmonary artery aneurysm are congenital heart defects
with left-to-right shunts and pulmonic valve abnormalities. There are also numerous causes
of acquired pulmonary artery aneurysms, including infection, vasculitis, pulmonary arterial
hypertension, trauma, neoplasm and pulmonary embolism. Symptoms of PA aneurysm are
usually non-specific, and physical examination findings are variable depending on the underlying
cause. Work-up includes various imaging modalities, transthoracic echocardiography, and right
heart catheterization. The gold standard treatment is surgery, but in select patients, conservative
management with close monitoring can be pursued.
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