Eisenmenger syndrome combined with pulmonary artery dissecting aneurysm

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A 52-year-old woman visited the emergency room with chest pain that felt like tearing caused by an emotional outburst. She had a previous medical history of the untreated atrial septal defect and pulmonary hypertension. An emergency cardiac ultrasound showed the presence of an atrial septal defect, pulmonary hypertension (Eisenmenger's syndrome), and pulmonary artery dissection. A cardiac macrovascular computed tomography angiogram confirmed the atrial septal defect Panel A, arrowhead), pulmonary hypertension, pulmonary artery thrombosis in situ (Panels B and C, asterisk), and a dissecting aneurysm of the pulmonary artery (Panels C and D, arrowhead; Supplementary material online, Videos S1 and S2). Pulmonary artery dissection is an infrequent and often fatal complication of chronic pulmonary hypertension, with imaging features similar to aortic dissection. This condition often presents as cardiogenic shock or sudden death and is usually diagnosed during an autopsy rather than while the patient is alive. Following a multidisciplinary consultation, the patient was treated with medication and was discharged after experiencing relief from chest pain and achieving a stable condition.

Supplementary data is available at European Heart Journal online.

All authors declare no conflict of interest for this contribution.