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Arano T, Imamoto T, Suda R, Kasai H, Sugiura T, Shigeta A, Yamamoto K, Nagata J, Sakao S, Tanabe N, Tatsumi K. Heritable pulmonary arterial hypertension complicated by multiple pulmonary arteriovenous malformations. Respir Med Case Rep 2021; 32:101352. [PMID: 33537202 PMCID: PMC7841351 DOI: 10.1016/j.rmcr.2021.101352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/08/2020] [Accepted: 01/13/2021] [Indexed: 11/15/2022] Open
Abstract
Heritable pulmonary arterial hypertension (HPAH) is a type of familial pulmonary arterial hypertension, while pulmonary arteriovenous malformations (PAVMs) are abnormal communications between pulmonary arteries and veins that occur frequently in patients with hereditary hemorrhagic telangiectasia (HHT). A 21-year-old woman on continuing medication for HPAH was hospitalized. She had been diagnosed with HPAH at age 4 years and had been receiving epoprostenol infusion from age of 9 years. Although lung perfusion scintigraphy showed a shunt fraction of 18.9% at age of 19 years, the cause of the shunt was unclear. At the time of the present hospitalization, enhanced computed tomography (CT) of the chest and four-dimensional reconstructed images revealed multiple abnormal communications between the peripheral pulmonary arteries and veins. Furthermore, right heart catheterization revealed an elevated mean pulmonary arterial pressure. Wedged angiography of the pulmonary artery of the right lower lobe revealed several PAVMs. Multiple PAVMs and suspected HHT with HPAH was diagnosed. The possibility of PAVMs should be considered even in patients with HPAH. Moreover, evaluation of the shunt fraction by lung perfusion scintigraphy and morphological examination of PAVM by contrast-enhanced CT may facilitate PAVM detection in patients with HPAH.
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Affiliation(s)
- Takahiro Arano
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takuro Imamoto
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Rika Suda
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hajime Kasai
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Health Professional Development Center, Chiba University Hospital, Chiba, Japan
| | - Toshihiko Sugiura
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Respiratory Medicine, Chibaken Saiseikai Narashino Hospital, Narashino, Japan
| | - Ayako Shigeta
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Keiko Yamamoto
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Jun Nagata
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Respiratory Medicine, Chibaken Saiseikai Narashino Hospital, Narashino, Japan
| | - Seiichiro Sakao
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nobuhiro Tanabe
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Department of Respiratory Medicine, Chibaken Saiseikai Narashino Hospital, Narashino, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Kasai H, Sugiura T, Arano T, Shoji H, Jujo T, Sakao S, Tanabe N, Tatsumi K. Adult Partial Anomalous Pulmonary Venous Connection With Drainage to Left Atrium and Inferior Vena Cava Clearly Visualized on a Combination of Multiple Imaging Techniques. Circ J 2017; 81:1547-1549. [DOI: 10.1253/circj.cj-17-0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hajime Kasai
- Department of Respirology, Graduate School of Medicine, Chiba University
| | - Toshihiko Sugiura
- Department of Respirology, Graduate School of Medicine, Chiba University
| | - Takahiro Arano
- Department of Medicine, School of Medicine, Chiba University
| | - Hiroki Shoji
- Department of Respirology, Graduate School of Medicine, Chiba University
| | - Takayuki Jujo
- Department of Respirology, Graduate School of Medicine, Chiba University
- Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University
| | - Seiichiro Sakao
- Department of Respirology, Graduate School of Medicine, Chiba University
| | - Nobuhiro Tanabe
- Department of Respirology, Graduate School of Medicine, Chiba University
- Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University
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