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Classical image of the pulmonary artery aneurysm secondary to idiopathic pulmonary hypertension

Pulmonary artery aneurysm (PAA) is a rare condition that may be idiopathic or the result of several pathologies, such as congenital cardiac anomalies associated with pulmonary hypertension, pulmonary valve stenosis, Behcet’s disease and generalized vasculitis, infections and trauma. PAA is most commonly caused by trauma (often iatrogenic) or infections. We are reporting a case of 67-year-old gentleman presented to us with history of exertional dyspnea since 6 months. On examination his Blood pressure and Body mass index was within normal limits. Clinical examination of the cardiovascular system revealed both systolic and diastolic murmurs without any systolic click in the left parasternal border. Chest X-ray showed enlarged pulmonary artery. Multidetector Computed Tomography revealed a huge pulmonary artery aneurysm in the left chest occupying almost half of the thoracic cavity (Figure 1). Subsequent cardiac catheterization confirmed aneurysmatic dilatation of the main pulmonary artery without any shunt. After other possible causes were all sought carefully in detail, the diagnosis of idiopathic pulmonary hypertension with pulmonary artery aneurysm was made in this patient.