Hankins G D, Brekken A L, Davis L M
Obstet Gynecol. 1985 Mar;65(3 Suppl):45S-48S.
True aneurysms of the pulmonary artery are most frequently associated with congenital heart lesions that have lead to sustained high pulmonary artery flow rates and pulmonary hypertension. A maternal death secondary to a dissecting aneurysm of the pulmonary artery is presented. Death occurred 17 hours postpartum, and the acute dissection may have been precipitated by the high flow rates accompanying parturition or, alternatively, by the Valsalva maneuver. The authors suggest a baseline chest radiograph and electrocardiogram in all women with known or suspected congenital heart disease to evaluate for pulmonary hypertension and pulmonary artery aneurysms. The occurrence of symptoms such as dyspnea or chest pain warrants repeat evaluation with strong consideration being given to right heart catheterization and pulmonary angiography. If a dissecting aneurysm is diagnosed, then emergency surgical repair seems warranted in view of the rapidity with which this condition progresses to death.
肺动脉真性动脉瘤最常与先天性心脏病变相关，这些病变导致持续的高肺动脉血流速度和肺动脉高压。本文报告了一例因肺动脉夹层动脉瘤导致的产妇死亡病例。患者产后17小时死亡，急性夹层可能是由分娩时的高血流速度或瓦尔萨尔瓦动作诱发的。作者建议对所有已知或疑似患有先天性心脏病的女性进行基线胸部X光片和心电图检查，以评估是否存在肺动脉高压和肺动脉动脉瘤。出现呼吸困难或胸痛等症状时，有必要再次进行评估，并充分考虑进行右心导管检查和肺血管造影。如果诊断为夹层动脉瘤，鉴于这种情况进展至死亡的速度很快，紧急手术修复似乎是必要的。
