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Case Reports
. 2004 Nov;90(11):e63.
doi: 10.1136/hrt.2004.039198.

Massive pulmonary artery thrombosis with haemoptysis in adults with Eisenmenger's syndrome: a clinical dilemma

C Broberg  1 , M Ujita, S Babu-Narayan, M Rubens, S K Prasad, J S R Gibbs, M A Gatzoulis
Affiliations
Case Reports

Massive pulmonary artery thrombosis with haemoptysis in adults with Eisenmenger's syndrome: a clinical dilemma

C Broberg et al. Heart. 2004 Nov.

Abstract

Although the frequency of haemoptysis in Eisenmenger's syndrome is well recognised, the high prevalence of pulmonary artery thrombus has been newly appreciated through the growing use of non-invasive imaging. Three patients with Eisenmenger's syndrome with haemoptysis are reported who underwent computed tomography pulmonary angiography and cardiovascular magnetic resonance. Each patient was found to have aneurysmal dilatation of the right pulmonary artery with large laminar thrombus. These cases illustrate a rising clinical problem in this special population-that is, how to treat and prevent large pulmonary artery thrombosis in the setting of haemoptysis. The authors discuss their approach to these cases and the known literature.

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Figures

Figure 1
Figure 1
(Top) Computed tomography pulmonary angiography (CTPA) transaxial images and (bottom) oblique coronal reformation with maximum intensity projection for each patient. LV, left ventricle; RPA, right pulmonary artery; Th, thrombus.
Figure 2
Figure 2
True fast imaging steady precession magnetic resonance images of each patient. ASD, atrial septal defect; MPA, main pulmonary artery; RA, right atrium; RV, right ventricle; Th, thrombus; VSD, ventricular septal defect. Case 1: (A) coronal slice showing the large RPA with Th;(B) transaxial slice showing the bifurcation of the MPA, with the RPA almost completely full of Th; (C) oblique transaxial cut in early systole showing the ASD. Case 2: (D) coronal slice; (E) sagittal slice through right lung, with Th occluding the majority of the RPA lumen; (F) oblique coronal slice showing the VSD. Case 3: (G) coronal slice with Th on the roof of the large RPA, with atrial baffles partly seen adjacent to the LV; (H) oblique transaxial slice showing anterior RV (systemic ventricle), posterior LV (pulmonary ventricle), and huge RPA with clot also anterior; (I) sagittal view from the left, showing the relation of LV to RPA.
See this image and copyright information in PMC

References

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