Massive haemoptysis in a patient with right pulmonary artery atresia with contralateral pulmonary artery pseudoaneurysm: a therapeutic dilemma in collateral-dependent pulmonary circulation.
Saby Anna Kunjumon, Upendra Panday, Pranshu Kumar Singh et al.
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Case in brief
A woman in her 30s presented with recurrent massive haemoptysis and chronic respiratory symptoms, including fever, cough, and breathlessness. Previous anti-tubercular therapy was ineffective. CT angiography revealed right pulmonary artery atresia with extensive systemic collaterals and a partially thrombosed pseudoaneurysm, leading to pulmonary infarction. Despite embolisation of the pseudoaneurysm, she developed hypoxaemic respiratory failure and ultimately died.
What made this case unusual
The case illustrates the delayed recognition of unilateral pulmonary artery atresia in adulthood, which is uncommon and complicates management.
Diagnostic / clinical pearl
Clinicians should consider pulmonary artery atresia in adults presenting with massive haemoptysis and chronic respiratory symptoms, especially when previous treatments fail.
Why it matters
This case underscores the complexities in managing collateral-dependent pulmonary circulation and the risks associated with interventions in such patients.