Ruptured pulmonary artery aneurysm with prior dissection and persistent ductus arteriosus: Autopsy case report

Area of Science:

• Cardiovascular Pathology
• Forensic Medicine
• Medical Genetics

Background:

• Cardiac tamponade, often fatal, can result from ruptured intrathoracic organs.
• Pulmonary artery aneurysms (PAA) are uncommon vascular abnormalities, frequently linked to congenital heart disease (CHD).

Observation:

• A 62-year-old woman with no prior medical history experienced sudden, unexpected death.
• Forensic autopsy revealed 500 ml of hemopericardium, indicative of cardiac tamponade.
• Dissection identified a saccular aneurysm in the pulmonary artery trunk with evidence of prior dissection and a co-existing persistent ductus arteriosus (PDA).

Findings:

• The case highlights a rare instance of hemopericardium originating from a ruptured pulmonary artery aneurysm.
• The presence of persistent ductus arteriosus (PDA) suggests a potential congenital etiology for the pulmonary artery aneurysm (PAA).
• Secondary pulmonary hypertension likely contributed to medial degeneration, increasing the risk of dissection and rupture.

Implications:

• This case underscores the importance of meticulous examination of great vessels and congenital anomalies during forensic autopsies, particularly in cases of sudden unexpected death.
• Identifying rare vascular pathologies like pulmonary artery aneurysms is crucial for determining cause of death and understanding associated congenital conditions.
• Awareness of the association between PDA and PAA can aid in the diagnosis and management of at-risk individuals.