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[Azygos vein aneurysm occurring simultaneously with hemoptysis].

Eiki Ichihara1, Masahiro Kaneko, Hiroshi Fujii

  • 1Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine.

Nihon Kokyuki Gakkai Zasshi = the Journal of the Japanese Respiratory Society
|July 25, 2007
PubMed
Summary

Pacemaker-induced superior vena cava occlusion led to azygos vein aneurysm and elevated bronchial vein pressure, causing hemoptysis in a 64-year-old man.

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Area of Science:

  • Cardiovascular Medicine
  • Pulmonology
  • Medical Imaging

Background:

  • Superior vena cava (SVC) occlusion is a rare complication.
  • Pacemaker leads are a known cause of SVC thrombosis.
  • Azygos vein (AV) dilation and rupture can occur secondary to venous hypertension.

Purpose of the Study:

  • To investigate the cause of hemoptysis in a patient with SVC occlusion.
  • To elucidate the pathophysiological mechanism linking pacemaker-induced SVC occlusion to hemoptysis.

Main Methods:

  • Case report of a 64-year-old male patient.
  • Diagnostic imaging: Chest X-ray, enhanced computed tomography (CT).
  • Endoscopic examination: Bronchoscopy.

Main Results:

  • Chest X-ray revealed a right tracheobronchial angle nodule.
  • Enhanced CT demonstrated complete SVC occlusion and an AV aneurysm.
  • Bronchoscopy showed dilated submucosal bronchial vessels at the right second carina.

Conclusions:

  • Long-term pacemaker placement likely caused SVC occlusion.
  • Collateral circulation rerouted blood to the AV, causing aneurysm formation and venous hypertension.
  • Elevated bronchial vein pressure led to vessel rupture and hemoptysis.