Saha Biplab Kumar, Beegle Scott
Pulmonary and Critical Care Medicine, Albany Medical Center Hospital, Albany, New York, USA
Pulmonary and Critical Care Medicine, Albany Medical Center Hospital, Albany, New York, USA.
BMJ Case Rep. 2019 Nov 25;12(11):e232468. doi: 10.1136/bcr-2019-232468.
Patients with pulmonary arterial hypertension (PAH) usually die from progressive right ventricular failure. Mechanical complications due to pulmonary artery (PA) enlargement are rare and include tracheobronchial and left main coronary artery compression, and PA dissection. A 62-year-old female with PAH was seen in our office for follow-up. During the evaluation, spirometry was performed, which revealed a severe obstructive ventilatory limitation. Subsequent workup identified compression of bilateral mainstem bronchi from the dilated PA as the aetiology for the abnormal spirometry. Very few cases of this rare complication have been reported in the literature. A significant dilation of the PA is necessary (>4 cm) for the occurrence of these complications. Dilation of PA is an independent risk factor for sudden unexpected death in patients with PAH.
肺动脉高压（PAH）患者通常死于进行性右心室衰竭。肺动脉（PA）扩张引起的机械性并发症较为罕见，包括气管支气管和左主冠状动脉受压以及PA夹层。一名62岁的PAH女性患者前来我们科室进行随访。在评估过程中，进行了肺功能测定，结果显示存在严重的阻塞性通气受限。随后的检查确定，扩张的PA对双侧主支气管的压迫是肺功能测定异常的病因。文献中报道的这种罕见并发症的病例非常少。这些并发症的发生需要PA显著扩张（>4厘米）。PA扩张是PAH患者突然意外死亡的独立危险因素。
