title: Fatal pulmonary arterial dissection and sudden death as initial manifestation of primary pulmonary hypertension: a case report.
abstract: We report a rare case of sudden death due to cardiac tamponade following intrapericardial rupture of a main pulmonary artery dissecting aneurysm. On pathology examination, the pulmonary artery showed an intimal tear in an arterial wall area with reduced thickness. However, no degenerative, inflammatory or necrotic processes were evident within the vessel wall. Hypertrophy of the wall of vasa vasorum in the adventitia of the pulmonary artery was found, as well as bilaterally diffuse myointimal arterial hyperplasia of the lung vasculature. According to these findings, we conclude that pulmonary artery rupture occurred in a patient with chronic unrecognized primary pulmonary hypertension.
authors.affiliation: Department of Morbid Pathology, Faculty of Medicine A. Gemelli, Catholic University of Sacred Heart, Largo Francesco Vito 1, 00168 Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Arena
authors.forename: Fabio
authors.initials: F
authors.lastname: De Giorgio
authors.forename: Antonio
authors.initials: A
authors.lastname: Abbate
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Capelli
authors.forename: Domenico
authors.initials: D
authors.lastname: De Mercurio
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Carbone
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000209:etiology* / Q000473:pathology; D017542:Aneurysm, Ruptured; D002305:Cardiac Tamponade / Q000209:etiology; D003645:Death, Sudden / Q000209:etiology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000473:pathology; D008297:Male; D011651:Pulmonary Artery / Q000473:pathology*; D012422:Rupture, Spontaneous / Q000209:etiology*