History

Fact Explanation
Incidental finding on autopsy Pulmonary artery aneurysm is a rare anomaly found in around 1 of every 14 000 autopsies and most are present in the main pulmonary artery. The cause could be idiopathic, but other causes include congenital shunt disease, syphilis, atherosclerosis, trauma, and pulmonary hypertension. In >50% of the postmortem cases, pulmonary aneurysms were associated with congenital heart disease, most frequently patent ductus arteriosus [1] [2] [3]
Asymptomatic [2] [6] Most are asymptomatic and diagnosed by incidental echocardiography [2][5] [6]
Dyspnoea on exertion [2] [3] Persistent pulmonary regurgitation due to dilatation results in right ventricular dilatation and eventual right heart failure which presents as this [2]
Cough, sometimes with haemoptysis. [2] [3] [7] [8] Approximately one-third of the patients with pulmonary artery aneurysms die of sudden severe hemoptysis due to rupture of the aneurysm. Although uncommon, Rasmussen pulmonary aneurysms are an important cause for massive hemoptysis in patients with tuberculosis. [7] [8]
Ankle swelling, reduced exercise tolerance and symptoms suggestive of right heart failure Persistent pulmonary regurgitation due to dilatation results in right ventricular dilatation and eventual right heart failure which presents as this [7]
Acute shortness of breath [3] This is a symptom of pulmonary embolism and It is assumed that low-pressure pulmonary artery aneurysm might be a source of recurrent emboli because of stasis and endothelial dysfunction [3]
Left-sided chest pain [3] This is a symptom of pulmonary embolism and It is assumed that low-pressure pulmonary artery aneurysm might be a source of recurrent emboli because of stasis and endothelial dysfunction [3]
Cyanosis [5] This is a symptom of pulmonary artery dissection as a consequence of abnormal dilatation. Dissection results in hemorrhagic shock and resultant cyanosis. Dissection of a markedly dilated pulmonary artery is a rare and usually fatal complication of chronic pulmonary arterial hypertension.[5]
Hemorrhagic shock [5] This is a symptom of pulmonary artery dissection as a consequence of abnormal dilatation. Dissection results in hemorrhagic shock due to excessive bleeding from severe hemoptysis . [5]
Acute pericardial tamponade [5] This is a symptom of pulmonary artery dissection as a consequence of abnormal dilatation.[5]
Sudden death [5] [7] This is a symptom of pulmonary artery dissection as a consequence of abnormal dilatation. Dissection results in hemorrhagic shock due to excessive internal bleeding or severe hemoptysis and sudden death.[5] [7]
General weakness, fever, rashes, mouth and genital ulcers [2] Suggestive of underlying disease for pulmonary artery aneurysm such as Behcet’s disease (BD). It's a multi systemic disease characterized by recurrent mouth ulcerations, genital ulcerations, ocular inflammation and skin lesions. Vasculitis caused by BD can occur in three forms and they are venous occlusion and varix formation, arterial occlusion and/or pulseless disease, and arterial aneurysm formation [4]
References
  1. SEGUCHI M., WADA H., SAKAKURA K., KUBO N., IKEDA N., SUGAWARA Y., YAMAGUCHI A., AKO J., MOMOMURA S.-I.. Idiopathic Pulmonary Artery Aneurysm. Circulation [online] December, 124(14):e369-e370 [viewed 03 July 2014] Available from: doi:10.1161/​CIRCULATIONAHA.111.029033
  2. VISTARINI N, AUBERT S, GANDJBAKHCH I, PAVIE A. Surgical treatment of a pulmonary artery aneurysm. European Journal of Cardio-Thoracic Surgery [online] 2007 June, 31(6):1139-1141 [viewed 03 July 2014] Available from: doi:10.1016/j.ejcts.2007.03.014
  3. ERASLI EVA, ANTONIADOU ΜARIA, STEIROPOULOS PASCHALIS, VASSILIADIS KONSTANTINOS, MANTZOURANI STAMATIA, PAPOULIDIS PAVLOS, TSARA VENETIA. Low-pressure pulmonary artery aneurysm presenting with pulmonary embolism: a case series. Array [online] 2011 December [viewed 03 July 2014] Available from: doi:10.1186/1752-1947-5-163
  4. HAMMAD AM, AL-QAHTANI SM, AL-ZAHRANI MA. Huge pulmonary artery aneurysm Can Respir J [online] 2009, 16(3):93-95 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706676
  5. SMALCELJ A, BRIDA V, SAMARZIJA M, MATANA A, MARGETIC E, DRINKOVIC N. Giant, Dissecting, High-Pressure Pulmonary Artery Aneurysm: Case Report of a 1-Year Natural Course Tex Heart Inst J [online] 2005, 32(4):589-594 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351839
  6. MAYORAL-CAMPOS VICTORIA, DE BENITO-ARéVALO JOSé LUIS, VAREA-SANZ MARZO ANTONIO. Pulmonary Artery Aneurysm. Archivos de Bronconeumología (English Edition) [online] 2013 December, 49(12):551-552 [viewed 03 July 2014] Available from: doi:10.1016/j.arbr.2013.10.006
  7. BLADES B., FORD W., CLARK P.. Pulmonary Artery Aneurysms: Report of a Case Treated by Surgical Intervention. Circulation [online] 1950 October, 2(4):565-571 [viewed 03 July 2014] Available from: doi:10.1161/01.CIR.2.4.565
  8. CORR PETER. Pulmonary Artery Aneurysm as a Cause of Massive Hemoptysis: Diagnosis and Management. Case Reports in Radiology [online] 2011 December, 2011:1-2 [viewed 03 July 2014] Available from: doi:10.1155/2011/141563

Examination

Fact Explanation
No signs on examination [1] Most are asymptomatic and diagnosed by incidental echocardiography therefore no signs on clinical examination. [1] [4] [5]
Respiratory distress [2] This is a symptom of pulmonary embolism and It is assumed that low-pressure pulmonary artery aneurysm might be a source of recurrent emboli because of stasis and endothelial dysfunction [2]
Cyanosis [2] This is a symptom of pulmonary embolism and It is assumed that low-pressure pulmonary artery aneurysm might be a source of recurrent emboli because of stasis and endothelial dysfunction [2]
Dependent oedema [1] [4] [5] Persistent pulmonary regurgitation due to dilatation results in right ventricular dilatation and eventual right heart failure which presents as this [1] [4] [5]
Elevation of jugular venour pressure [1] [4] [5] Persistent pulmonary regurgitation due to dilatation results in right ventricular dilatation and eventual right heart failure which presents as this [1] [4] [5]
Clubbing of the fingers [7] As pulmonary artery aneurysms are associated frequently with pulmonary hypertension and persistent pulmonary hypertension results in chronic hypoxia and clubbing [7]
Plethora [7] As pulmonary artery aneurysms are associated frequently with pulmonary hypertension and persistent pulmonary hypertension results in chronic hypoxia and increased erythropoietin secretion and polycythaemia [7]
Precordial bulge [6] Due to underlying aneurysm [6]
Epigastric pulsations [6] Due to underlying aneurysm and also due to pulsatile liver associated with right heart failure which occurs due to right ventricular dilatation due to pulmonary regurgitation [6]
Palpable 2nd heart sound [1] As pulmonary artery aneurysms are associated frequently with pulmonary hypertension and this results in increased sound in pulmonary valve closure [1]
Loud 2nd heart sound [1] As pulmonary artery aneurysms are associated frequently with pulmonary hypertension and this results in increased sound in pulmonary valve closure [1]
Parasternal heave [1] [2] Persistent pulmonary regurgitation due to dilatation results in right ventricular dilatation and hypertrophy. [1] [2]
Holosystolic murmur at left lower sternal edge [1] Due to functional tricuspid regurgitation which occurs due to right ventricular dilatation [1]
Early diastolic murmur heard in the pulmonary area [1] Due to associated pulmonary regurgitation due to aneurysm [1]
Cold clammy peripheries, Cyanosis, low blood pressure, Rapid thready pulse [1] [4] [5] This is a symptom of pulmonary artery dissection as a consequence of abnormal dilatation. Dissection results in hemorrhagic shock due to excessive bleeding from severe hemoptysis[1] [4] [5]
References
  1. SEGUCHI M., WADA H., SAKAKURA K., KUBO N., IKEDA N., SUGAWARA Y., YAMAGUCHI A., AKO J., MOMOMURA S.-I.. Idiopathic Pulmonary Artery Aneurysm. Circulation [online] December, 124(14):e369-e370 [viewed 03 July 2014] Available from: doi:10.1161/CIRCULATIONAHA.111.029033
  2. ERASLI EVA, ANTONIADOU ΜARIA, STEIROPOULOS PASCHALIS, VASSILIADIS KONSTANTINOS, MANTZOURANI STAMATIA, PAPOULIDIS PAVLOS, TSARA VENETIA. Low-pressure pulmonary artery aneurysm presenting with pulmonary embolism: a case series. Array [online] 2011 December [viewed 03 July 2014] Available from: doi:10.1186/1752-1947-5-163
  3. VISTARINI N, AUBERT S, GANDJBAKHCH I, PAVIE A. Surgical treatment of a pulmonary artery aneurysm. European Journal of Cardio-Thoracic Surgery [online] 2007 June, 31(6):1139-1141 [viewed 03 July 2014] Available from: doi:10.1016/j.ejcts.2007.03.014
  4. SMALCELJ A, BRIDA V, SAMARZIJA M, MATANA A, MARGETIC E, DRINKOVIC N. Giant, Dissecting, High-Pressure Pulmonary Artery Aneurysm: Case Report of a 1-Year Natural Course Tex Heart Inst J [online] 2005, 32(4):589-594 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351839
  5. MAYORAL-CAMPOS VICTORIA, DE BENITO-ARéVALO JOSé LUIS, VAREA-SANZ MARZO ANTONIO. Pulmonary Artery Aneurysm. Archivos de Bronconeumología (English Edition) [online] 2013 December, 49(12):551-552 [viewed 03 July 2014] Available from: doi:10.1016/j.arbr.2013.10.006
  6. GARG G, TYAGI H, AGRAWAL G, ANIL SR. Giant pulmonary artery aneurysm in a 6-year-old child Indian Heart J [online] 2014 Jan, 66(1):141-142 [viewed 03 July 2014] Available from: doi:10.1016/j.ihj.2013.12.030
  7. BLADES B., FORD W., CLARK P.. Pulmonary Artery Aneurysms: Report of a Case Treated by Surgical Intervention. Circulation [online] 1950 October, 2(4):565-571 [viewed 03 July 2014] Available from: doi:10.1161/01.CIR.2.4.565

Differential Diagnoses

Fact Explanation
Behcet disease [2] [4] [5] Behçet's syndrome is a chronic multisystem form of vasculitis characterized by recurrent oral and genital ulcers and uveitis. they typically involve the right lower lobe arteries with frequent thrombosis and surrounding inflammation [2] [5]
Primary pulmonary hypertension [2] This is frequently associated with pulmonary artery aneurysm formation and signs are similar in both conditions. [2]
Congenital heart disease like patent Ductus Arteriosus, ventricular septal defects [1] It's thought to be that >50% of pulmonary aneurysms were associated with congenital heart disease, most frequently patent ductus arteriosus. increased flow due to congenital heart disease resulting in pulmonary artery volume and pressure overload leading to aneurysm formation [1]
Marfan's syndrome [2] [4] This results in Intrinsic weakness in the arterial wall due to connective tissue abnormalities and resultant cystic medial necrosis also predispose to aneurysm formation. [2]
Hughes-Stovin syndrome [2] [5] Hughes-Stovin syndrome is characterized by recurrent thrombophlebitis and pulmonary artery aneurysm formation and rupture [2] [5]
Syphilis [2] [4] Vascular involvement in late syphilis or cardiovascular syphilis is due to an obliterative small vessel endarteritis, usually of the vasa vasorum of the thoracic aorta, fostering loss of structural integrity of the tunica media and subsequent fibrosis and calcification. This frequently involve aorta but can involve pulmonary arteries as well [4]
Tuberculosis [2] [3] [4] This results in pseudo-aneurysm formation. They are known as Rasmussen aneurysms and usually involve the upper lobes in the setting of reactivation tuberculosis [2] [3]
References
  1. SEGUCHI M., WADA H., SAKAKURA K., KUBO N., IKEDA N., SUGAWARA Y., YAMAGUCHI A., AKO J., MOMOMURA S.-I.. Idiopathic Pulmonary Artery Aneurysm. Circulation [online] December, 124(14):e369-e370 [viewed 03 July 2014] Available from: doi:10.1161/CIRCULATIONAHA.111.029033
  2. HAMMAD AM, AL-QAHTANI SM, AL-ZAHRANI MA. Huge pulmonary artery aneurysm Can Respir J [online] 2009, 16(3):93-95 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706676
  3. CORR PETER. Pulmonary Artery Aneurysm as a Cause of Massive Hemoptysis: Diagnosis and Management. Case Reports in Radiology [online] 2011 December, 2011:1-2 [viewed 03 July 2014] Available from: doi:10.1155/2011/141563
  4. TOMEY M. I., MURTHY V. L., BECKMAN J. A.. Giant syphilitic aortic aneurysm: A case report and review of the literature. Vascular Medicine [online] December, 16(5):360-364 [viewed 03 July 2014] Available from: doi:10.1177/1358863X11417614
  5. LEE WY, HOON CS, KIM HR. Massive Hemoptysis Caused by Atypical Behcet's Disease Korean J Thorac Cardiovasc Surg [online] 2014 Apr, 47(2):178-180 [viewed 03 July 2014] Available from: doi:10.5090/kjtcs.2014.47.2.178

Investigations - for Diagnosis

Fact Explanation
Chest x-ray [1] Chest radiography usually shows right atrial and right ventricular enlargement, and enormous dilatation of the pulmonary artery and its branches [2]
Echocardiogram [1] Echocardiography usually shows dilated pulmonary artery and it's branches and enlarged right side of the heart with moderate pulmonary and tricuspid insufficiency indicating severe pulmonary hypertension [2]
CT- chest [1] [8] This gives the diameters of the dilated pulmonary artery and it's branches [2] [8]
Digital pulmonary arteriography [2] it also shows pulmonary artery aneurysm and scant opacification of its branches with contrast dilution. [2]
Caridaic catheterization [2] Catheterization of the right side of the heart demonstrates elevated systolic pulmonary artery pressure [2]
Full blood count [3] Due to polycythaemia due to chronic hypoxia associated with pulmonary hypertension [3]
Serological tests for syphilis screening [4] [7] As Syphilis can be the cause of aneurysm formation, it's important to screen for syphilis [4] [7]
Mantoux test [5] As Tuberculosis can be the cause of aneurysm formation, it's important to screen for Tuberculosis with a mantoux test [5] [7]
Screening tests for Bechet's disease with Pathergy Test [6] As this disease can be the cause of aneurysm formation, it's important to screen for this. But the tests are limited but Pathergy Test can be performed in which there's occurrence of a small red bump or pustule at the site of minor trauma to the skin [6] [7]
References
  1. TING P, JUGDUTT BI, LE TAN J. Large pulmonary artery aneurysm associated with Marfan syndrome Int J Angiol [online] 2010, 19(1):e48-e50 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2949994
  2. SMALCELJ A, BRIDA V, SAMARZIJA M, MATANA A, MARGETIC E, DRINKOVIC N. Giant, Dissecting, High-Pressure Pulmonary Artery Aneurysm: Case Report of a 1-Year Natural Course Tex Heart Inst J [online] 2005, 32(4):589-594 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351839
  3. BLADES B., FORD W., CLARK P.. Pulmonary Artery Aneurysms: Report of a Case Treated by Surgical Intervention. Circulation [online] 1950 October, 2(4):565-571 [viewed 03 July 2014] Available from: doi:10.1161/01.CIR.2.4.565
  4. RATNAM S. The laboratory diagnosis of syphilis Can J Infect Dis Med Microbiol [online] 2005, 16(1):45-51 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2095002
  5. NAYAK S, ACHARJYA B. Mantoux test and its interpretation Indian Dermatol Online J [online] 2012, 3(1):2-6 [viewed 03 July 2014] Available from: doi:10.4103/2229-5178.93479
  6. DAVATCHI F. Diagnosis/Classification Criteria for Behcet's Disease Patholog Res Int [online] 2012:607921 [viewed 03 July 2014] Available from: doi:10.1155/2012/607921
  7. TOMEY M. I., MURTHY V. L., BECKMAN J. A.. Giant syphilitic aortic aneurysm: A case report and review of the literature. Vascular Medicine [online] December, 16(5):360-364 [viewed 03 July 2014] Available from: doi:10.1177/1358863X11417614
  8. GARG G, TYAGI H, AGRAWAL G, ANIL SR. Giant pulmonary artery aneurysm in a 6-year-old child Indian Heart J [online] 2014 Jan, 66(1):141-142 [viewed 03 July 2014] Available from: doi:10.1016/j.ihj.2013.12.030

Investigations - Fitness for Management

Fact Explanation
Full blood count [1] This is done to exclude significant anaemia and any quantitative platelet or leukocyte abnormality [1]
Serum creatinine, Blood urea nitrogen [1] To assess renal function prior to general anasthesia [1]
Coagulation profile [1] To exclude any coagulopathy prior to surgery [1]
Echocardiography [2] To assess the diameter of pulmonary artery, pressure, ejection fraction, dimensions of the cardiac chambers prior to surgery [2]
Cardio-Pulmonary exercise testing [2] To assess cardiac function prior to surgery [2]
Caridac catheterization [2] [3] To assess the pulmonary artery wedge pressure prior to surgery [2] [3]
References
  1. CORNELISSEN H.. Preoperative assessment for cardiac surgery. Continuing Education in Anaesthesia, Critical Care & Pain [online] 2006 June, 6(3):109-113 [viewed 3 July 2014] Available from: doi:10.1093/bjaceaccp/mkl013
  2. SCHWAIBLMAIR MARTIN, REICHENSPURNER HERMANN, MÜLLER CHRISTIAN, BRIEGEL JOSEF, FÜRST HEINER, GROH JÜRGEN, REICHART BRUNO, VOGELMEIER CLAUS. Cardiopulmonary Exercise Testing Before and After Lung and Heart–Lung Transplantation. Am J Respir Crit Care Med [online] 1999 April, 159(4):1277-1283 [viewed 3 July 2014] Available from: doi:10.1164/ajrccm.159.4.980511
  3. STRUTHERS R., ERASMUS P., HOLMES K., WARMAN P., COLLINGWOOD A., SNEYD J. R.. Assessing fitness for surgery: a comparison of questionnaire, incremental shuttle walk, and cardiopulmonary exercise testing in general surgical patients. British Journal of Anaesthesia [online] December, 101(6):774-780 [viewed 3 July 2014] Available from: doi:10.1093/bja/aen310

Investigations - Followup

Fact Explanation
Echocardiography [1] [2] [4] To assess the dilatation of pulmonary artery and it's branches and associated pulmonary hypertension [1] [2]
CT-chest with contrast [1] [2] [3] [4] To assess the dilatation of pulmonary artery and it's branches [1] [2] [3]
References
  1. TING P, JUGDUTT BI, LE TAN J. Large pulmonary artery aneurysm associated with Marfan syndrome Int J Angiol [online] 2010, 19(1):e48-e50 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2949994
  2. SMALCELJ A, BRIDA V, SAMARZIJA M, MATANA A, MARGETIC E, DRINKOVIC N. Giant, Dissecting, High-Pressure Pulmonary Artery Aneurysm: Case Report of a 1-Year Natural Course Tex Heart Inst J [online] 2005, 32(4):589-594 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351839
  3. GARG G, TYAGI H, AGRAWAL G, ANIL SR. Giant pulmonary artery aneurysm in a 6-year-old child Indian Heart J [online] 2014 Jan, 66(1):141-142 [viewed 03 July 2014] Available from: doi:10.1016/j.ihj.2013.12.030
  4. HAMMAD AM, AL-QAHTANI SM, AL-ZAHRANI MA. Huge pulmonary artery aneurysm Can Respir J [online] 2009, 16(3):93-95 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706676

Investigations - Screening/Staging

Fact Explanation
Echocardiography [1] [2] [3] To assess the diameter of the pulmonary artery and pressure and the right ventricular dimensions to determine the timing of surgical intervention [1]
CT-Chest [1] [2] [3] To assess the diameter of the pulmonary artery to determine the timing of surgical intervention [1]
References
  1. HAMMAD AM, AL-QAHTANI SM, AL-ZAHRANI MA. Huge pulmonary artery aneurysm Can Respir J [online] 2009, 16(3):93-95 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706676
  2. SEGUCHI M., WADA H., SAKAKURA K., KUBO N., IKEDA N., SUGAWARA Y., YAMAGUCHI A., AKO J., MOMOMURA S.-I.. Idiopathic Pulmonary Artery Aneurysm. Circulation [online] December, 124(14):e369-e370 [viewed 03 July 2014] Available from: doi:10.1161/​CIRCULATIONAHA.111.029033
  3. SERASLI EVA, ANTONIADOU ΜARIA, STEIROPOULOS PASCHALIS, VASSILIADIS KONSTANTINOS, MANTZOURANI STAMATIA, PAPOULIDIS PAVLOS, TSARA VENETIA. Low-pressure pulmonary artery aneurysm presenting with pulmonary embolism: a case series. Array [online] 2011 December [viewed 03 July 2014] Available from: doi:10.1186/1752-1947-5-163

Management - General Measures

Fact Explanation
Acute management of shock due to dissection of arteries and massive hemoptysis [1] Patient can present with massive hemoptysis and this should be managed accordingly.This starts with attending to airway, breathing and circulation and stabilize the patient with blood products.
Acute management of pulmonary embolism [2] This needs resuscitation and subsequent thrombolysis or surgical embolectomy depending on the patient [2]
Patient education [3] Patient should be educated on the condition, the aetiology, course and to identify life threatening conditions [3]
Diet [3] There shouldn't be any dietary restrictions apart from those in heart failure where low salt diet is recommended. [3]
Exercise [3] Strenuous exercises should be avoided and the moderate day to day activities can be done [3]
References
  1. HAKANSON E.. Management of life-threatening haemoptysis. [online] 2002 February, 88(2):291-295 [viewed 03 July 2014] Available from: doi:10.1093/bja/88.2.291
  2. TORBICKI A., PERRIER A, et al. Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). European Heart Journal [online] 2008 March, 29(18):2276-2315 [viewed 03 July 2014] Available from: doi:10.1093/eurheartj/ehn310
  3. SEGUCHI M., WADA H., SAKAKURA K., KUBO N., IKEDA N., SUGAWARA Y., YAMAGUCHI A., AKO J., MOMOMURA S.-I.. Idiopathic Pulmonary Artery Aneurysm. Circulation [online] December, 124(14):e369-e370 [viewed 03 July 2014] Available from: doi:10.1161/​CIRCULATIONAHA.111.029033

Management - Specific Treatments

Fact Explanation
Surgical management with grafting [2] [4] [5] The management of pulmonary artery aneurysm is not clearly established. Surgical intervention is generally recommended to symptomatic patients and in patients with underlying diseases or complications, left-to-right shunt, pulmonary arterial hypertension and large aneurysm size >6cm. Dacron interposition graft placement, autologous pericardial replacement of the main pulmonary artery can be done [1] [2]
Pulmonary arterial aneurysmorrhaphy/plication [2] [4] [5] This too can be done as surgical management [2]
Pulmonary valve replacement [2] This relieves right ventricular volume overload but also the associated haemodynamic burden on the vessel wall [2]
Heart–lung transplantation [3] For uncontrolled pulmonary hypertension, this remains the treatment though very risky. [3]
Pharmacological treatment for pulmonary hypertension [3] Treatment with vasodilators such as Sildenafil , Bosentan for pulmonary hypertension may be helpful if associated with pulmonary hypertension [3]
Pharmacological treatment for Behcet's disease [6] Immunosuppression with Azathioprine, Cyclophosphamide can be used as the main therapy for the treatment of pulmonary artery aneurysms in this Anti-TNF factors are indicated incase of unresponsiveness to immunosuppressive drugs. [6]
References
  1. SERASLI EVA, ANTONIADOU ΜARIA, STEIROPOULOS PASCHALIS, VASSILIADIS KONSTANTINOS, MANTZOURANI STAMATIA, PAPOULIDIS PAVLOS, TSARA VENETIA. Low-pressure pulmonary artery aneurysm presenting with pulmonary embolism: a case series. Array [online] 2011 December [viewed 03 July 2014] Available from: doi:10.1186/1752-1947-5-163
  2. VELDTMAN GR, DEARANI JA, WARNES CA. Low pressure giant pulmonary artery aneurysms in the adult: natural history and management strategies Heart [online] 2003 Sep, 89(9):1067-1070 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767844
  3. SMALCELJ A, BRIDA V, SAMARZIJA M, MATANA A, MARGETIC E, DRINKOVIC N. Giant, Dissecting, High-Pressure Pulmonary Artery Aneurysm: Case Report of a 1-Year Natural Course Tex Heart Inst J [online] 2005, 32(4):589-594 [viewed 03 July 2014] Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351839
  4. VISTARINI N, AUBERT S, GANDJBAKHCH I, PAVIE A. Surgical treatment of a pulmonary artery aneurysm. European Journal of Cardio-Thoracic Surgery [online] 2007 June, 31(6):1139-1141 [viewed 03 July 2014] Available from: doi:10.1016/j.ejcts.2007.03.014
  5. SEGUCHI M., WADA H., SAKAKURA K., KUBO N., IKEDA N., SUGAWARA Y., YAMAGUCHI A., AKO J., MOMOMURA S.-I.. Idiopathic Pulmonary Artery Aneurysm. Circulation [online] December, 124(14):e369-e370 [viewed 03 July 2014] Available from: doi:10.1161/CIRCULATIONAHA.111.029033
  6. TAKAHAMA M., YAMAMOTO R., NAKAJIMA R., TADA H.. Successful surgical treatment of pulmonary artery aneurysm in Behcet's syndrome. Interactive CardioVascular and Thoracic Surgery [online] 2008 December, 8(3):390-392 [viewed 03 July 2014] Available from: doi:10.1510/icvts.2008.194647