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Dissecting aortic aneurysm mimicking massive pulmonary embolism

M A Ossorio1, S A O'Grady, T M Roy

  • 1Division of Respiratory and Environmental Medicine, University of Louisville School of Medicine, KY 40292.

The Journal of the Kentucky Medical Association
|June 1, 1993
PubMed
Summary

A ventilation-perfusion lung scan showing a unilateral perfusion defect may not always indicate pulmonary embolism. Dissecting aortic aneurysms can mimic this finding, requiring further investigation.

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Area of Science:

  • Cardiovascular Medicine
  • Pulmonary Medicine
  • Diagnostic Imaging

Background:

  • Ventilation-perfusion (V/Q) lung scans are crucial for diagnosing pulmonary embolism (PE).
  • Unilateral defects on V/Q scans can suggest PE, but differential diagnoses must be considered.

Observation:

  • A patient presented with a massive unilateral segmental defect on V/Q lung scan, indicative of PE.
  • However, the patient was diagnosed with a dissecting aortic aneurysm compressing the right pulmonary artery.

Findings:

  • The V/Q scan finding of a unilateral perfusion defect is not pathognomonic for acute pulmonary embolism.
  • Dissecting aortic aneurysms can present as unilateral perfusion defects on V/Q scans.

Implications:

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  • Conditions causing unilateral perfusion defects warrant further diagnostic evaluation, such as pulmonary arteriography.
  • Accurate diagnosis is essential to guide appropriate treatment for potentially life-threatening conditions like aortic dissection and PE.