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).