Introduction
A 66-year-old female (BMI 32.61kg/m2) with a past medical history of hypertension, hyperlipidemia, type 2 diabetes mellitus, hypothyroidism, anxiety, obstructive sleep apnea, osteoarthritis, mechanical falls, paroxysmal atrial fibrillation/flutter (not on anti-coagulation) status post pulmonary vein isolation (2008) with repeat ablation/isolation (2014, 2016) and left atrial appendage (LAA) occlusion (2017) presented to her cardiologist for a routine visit where she underwent transthoracic echocardiography (TTE) and was found to have a pulmonary artery aneurysm (PAA). Her PAA measured 5.1cm distal to the pulmonic valve, and pulmonary artery (PA) systolic pressure was estimated to be 55mmHg. The aortic valve and root/ascending aorta size were measured as normal.
On exam, our patient lacked pathologic features of a connective tissue disorder, and she noted no family history of such. Her auscultatory exam did not reveal any murmurs/gallops that would suggest valvular disease. She denied angina, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, syncope, and change in exercise tolerance, but endorsed occasional episodes of palpitations and right-sided chest pain (attributed to acid reflux).