Conservative management of a large idiopathic pulmonary artery aneurysm: A case report.

Autor:	Turnow M; University of Pikeville Kentucky College of Osteopathic Medicine, Pikeville, KY, USA., Elston S; University of Pikeville Kentucky College of Osteopathic Medicine, Pikeville, KY, USA., Golzarian H; Mercy Health St. Rita's Medical Center, Internal Medicine Residency, Lima, OH, USA., Chanamolu S; Mercy Health Pulmonary Disease Center, St. Rita's Medical Center, Lima, OH, USA.
Jazyk:	angličtina
Zdroj:	Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2022 May 29; Vol. 78, pp. 103853. Date of Electronic Publication: 2022 May 29 (Print Publication: 2022).
DOI:	10.1016/j.amsu.2022.103853
Abstrakt:	Introduction and Importance: Pulmonary artery aneurysms are rare anomalies of the pulmonary vasculature. They are often asymptomatic and frequently an incidental finding on imaging or autopsy. It is imperative to closely monitor pulmonary artery aneurysms as they can result in sudden dissection, rupture, and death. Due to the rarity of this disease, the number of studies on pulmonary artery aneurysm management are limited and debated in the literature. Case Presentation: We report a case of an initially symptomatic patient with dyspnea on exertion with an incidental finding of a large 5.0 × 6.4 cm pulmonary artery aneurysm that responded well to conservative management. Her dyspnea self-resolved and the decision was made to closely monitor the patient every three months with serial computed tomography angiography imaging. Clinical Discussion: Idiopathic aneurysms of the main pulmonary artery are rare with a poorly understood pathogenesis primarily due to the limited number of cases. There are no clear guidelines for management, but the least invasive approach should be used due to the risk of serious adverse events. Pharmacologic treatment of underlying comorbidities and serial computed tomography angiography imaging should be considered as conservative management. Conclusion: Six months later, she remains hemodynamically stable and the aneurysm has decreased in size by 15%. This case highlights that conservative management should be considered first line therapy in asymptomatic, hemodynamically stable patients regardless of aneurysm size. Competing Interests: The authors have no conflict of interest to declare. (© 2022 The Authors.)
Databáze:	MEDLINE
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