Fatal haemoptysis due to ruptured aortic arch aneurysm with aorto-pulmonary fistula.
An 80-year-old woman presenting with a single episode of acute haemoptysis yielded a cup of fresh blood. She gave a history of acute onset breathlessness and retrosternal chest discomfort, breathlessness and chest discomfort (1 day). She had no history of pulmonary tuberculosis or bleeding diathesis. She was diagnosed with hypertension 20 years before, but she discontinued medications. On examination she was conscious, alert, pale and without cyanosis or icterus. Pulse rate was 100/mt, regular BP 200/140 mm of Hg right upper limb in the supine position. The radiograph of her chest showed an aortic arch aneurysm. A high-resolution computed scan of the chest showed a leaking aortic arch aneurysm with haemothorax and destruction of the bronchoalveolar architecture. Surgical correction was planned but she succumbed because of hypovolaemic shock. This case is reported as it is an important differential diagnosis of refractory haemoptysis.
Department of Internal Medicine, Medical College Hospital, Thiruvananthapuram, Kerala, India. drcrajasekharan@yahoo.com
Chandrasekharan
C
Rajasekharan
Madhu
M
Deepak
Narayanan Santhanavally
NS
Ratheesh
D000369:Aged, 80 and over; D001011:Aorta; D001019:Aortic Rupture / Q000150:complications* / Q000000981:diagnostic imaging*; D001164:Arteriovenous Fistula / Q000150:complications*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006469:Hemoptysis / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000150:complications; D011667:Pulmonary Veins; D011859:Radiography