Sagar Malvika, Marshall Anderson S, Clary Cody W, Qureshi Athar M
Department of Pediatrics, Mc Lane Children's Hospital. Baylor Scott and White Health, Temple, Texas, USA.
Department of Internal Medicine/Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
BMJ Case Rep. 2017 Oct 10;2017:bcr-2016-218885. doi: 10.1136/bcr-2016-218885.
Ductal origin of pulmonary artery is a rare anomaly that is frequently misdiagnosed. Patients may present with exertional dyspnoea, recurrent respiratory infections and pulmonary hypertension. The presence of pulmonary hypertension can adversely affect clinical outcome in these patients; hence, early identification and intervention is the key to improve survival. A case of a 3-year-old child presenting with exertional dyspnoea is presented in this report. Chest radiograph revealed right-sided pulmonary hypoplasia and mediastinal shift to the right. Pulmonary artery agenesis was suspected when CT of the chest demonstrated right-sided pulmonary artery agenesis. Cardiac catheterisation revealed the correct diagnosis of ductal origin of right pulmonary artery. The most striking feature of this case is that the clinical presentation is mild compared with the findings on imaging.
肺动脉导管起源是一种罕见的异常情况，常被误诊。患者可能出现劳力性呼吸困难、反复呼吸道感染和肺动脉高压。肺动脉高压的存在会对这些患者的临床结局产生不利影响；因此，早期识别和干预是提高生存率的关键。本报告介绍了一例3岁儿童出现劳力性呼吸困难的病例。胸部X线片显示右侧肺发育不全和纵隔右移。胸部CT显示右侧肺动脉缺如时，怀疑有肺动脉发育不全。心导管检查明确诊断为右肺动脉导管起源。该病例最显著的特点是临床表现与影像学检查结果相比相对较轻。
