[Multiple congenital stenoses of the segmental pulmonary arteries in an elderly patient]

Area of Science:

• Cardiology
• Pulmonology
• Vascular Medicine

Background:

• Congenital pulmonary artery stenoses are uncommon causes of pulmonary arterial hypertension, typically identified in childhood.
• Pulmonary arterial hypertension (PAH) significantly impacts cardiovascular health and prognosis.

Observation:

• A rare case of multiple arterial pulmonary malformations was diagnosed in an elderly patient presenting with acute severe pulmonary embolism.
• The patient demonstrated an excellent initial response to fibrinolysis, yet persistent pulmonary hypertension indicated an underlying vascular condition.

Findings:

• Pulmonary angiography confirmed type III multiple segmental arterial pulmonary stenoses.
• The patient experienced a favorable outcome, remaining well for eight years post-diagnosis.

Implications:

• This case suggests that pulmonary artery stenoses can have a good prognosis, even when diagnosed in adulthood.
• The findings highlight the potential for silent or misdiagnosed pulmonary artery lesions in the adult population, emphasizing the need for consideration in unexplained pulmonary hypertension.