1.A Case of Extrinsic Compression of the Left Main Coronary Artery Secondary to Pulmonary Artery Dilatation.
Yoon Jung CHOI ; Ung KIM ; Jin Sung LEE ; Won Jong PARK ; Sang Hee LEE ; Jong Seon PARK ; Dong Gu SHIN ; Young Jo KIM
Journal of Korean Medical Science 2013;28(10):1543-1548
Extrinsic compression of the left main coronary artery (LMCA) secondary to pulmonary artery dilatation is a rare syndrome. Most cases of pulmonary artery hypertension but no atherosclerotic risk factors rarely undergo coronary angiography, and hence, diagnoses are seldom made and proper management is often delayed in these patients. We describe a patient that presented with pulmonary hypertension, clinical angina, and extrinsic compression of the LMCA by the pulmonary artery, who was treated successfully by percutaneous coronary intervention. Follow-up coronary angiography showed patent stent in the LMCA in the proximity of the dilated main pulmonary artery. This case reminds us that coronary angiography and percutaneous coronary intervention should be considered in pulmonary hypertension patients presenting with angina or left ventricular dysfunction.
Angina Pectoris/etiology
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Angioplasty, Balloon, Coronary
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Coronary Angiography
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Coronary Stenosis/radiography/therapy
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Coronary Vessels/radiography/*ultrasonography
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Dilatation, Pathologic
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Female
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Humans
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Hypertension, Pulmonary/etiology/radiography
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Middle Aged
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Pulmonary Artery/radiography/*ultrasonography
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Stents
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Tomography, X-Ray Computed
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Ventricular Dysfunction, Left
2.Total Occlusion of Left Main Coronary Artery by Dilated Main Pulmonary Artery in a Patient with Severe Pulmonary Hypertension.
Juyong LEE ; Hyuck Moon KWON ; Bum Kee HONG ; Hae Kyoon KIM ; Ki Whan KWON ; Jae Young KIM ; Kyo Jun LEE ; Tae Soo KANG ; Dong Soo KIM ; Young Hak SHIN ; Jin Seon LEEM ; Hyun Seung KIM
The Korean Journal of Internal Medicine 2001;16(4):265-269
A 34-year-old woman was admitted to the hospital because of recently aggravated right heart failure without angina for 5 months. When she was 25 years old, patch repair with Polytetrafluoroethylene (PTFE) was performed for the secondum type of atrial septal defect (ASD) with moderate pulmonary hypertension. The chest PA, echocardiography and cardiac catheterization at current admission revealed Eisenmenger syndrome without intracardiac shunt. Chest CT scan with contrast revealed markedly dilated pulmonary trunk, both pulmonary arteries and concave disfigurement of the left side of the ascending aorta suggesting extrinsic compression, as well as total occlusion of the ostium of the left main coronary artery that was retrogradly filled with collateral circulation from the right coronary artery. The coronary angiography showed normal right coronary artery and the collaterals that come out from the conus branch to the mid-left anterior descending artery (LAD) and that from distal right coronary artery to the left circumflex artery (LCX) and to the distal LAD, respectively. On aortography, the left main coronary artery was not visualized with no stump, suggestive of total occlusion of the ostium of the left main coronary artery. From our experience, it is possible to say that the occlusion of the ostium of the left main coronary can be induced by the dilated pulmonary artery trunk due to ASD with pulmonary hypertension and that, if the ASD closure was too late, the narrowing or obstruction of the left coronary artery could not be resolved even after operation owing to irreversible pulmonary hypertension.
Adult
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Case Report
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Constriction, Pathologic/etiology/radiography
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Coronary Disease/*etiology/radiography
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Dilatation, Pathologic/etiology
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Eisenmenger Complex/diagnosis
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Female
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Heart Septal Defects, Atrial/*complications
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Human
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Hypertension, Pulmonary/*complications
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*Pulmonary Artery/radiography
3.Aortic Dissection Presenting with Secondary Pulmonary Hypertension Caused by Compression of the Pulmonary Artery by Dissecting Hematoma: A Case Report.
Dong Hun KIM ; Sang Wan RYU ; Yong Sun CHOI ; Byoung Hee AHN
Korean Journal of Radiology 2004;5(2):139-142
The rupture of an acute dissection of the ascending aorta into the space surrounding the pulmonary artery is an uncommon occurrence. No previous cases of transient pulmonary hypertension caused by a hematoma surrounding the pulmonary artery have been documented in the literature. Herein, we report a case of acute aortic dissection presenting as secondary pulmonary hypertension.
Aortic Aneurysm/*complications/diagnosis
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Aortic Rupture/*complications/diagnosis
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Constriction, Pathologic
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Female
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Hematoma/*complications
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Human
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Hypertension, Pulmonary/*etiology
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Middle Aged
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Pulmonary Artery/pathology/radiography
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Tomography, X-Ray Computed
4.Clinical Characteristics of Idiopathic Pulmonary Fibrosis Patients with Diabetes Mellitus: the National Survey in Korea from 2003 to 2007.
Yu Jin KIM ; Jeong Woong PARK ; Sun Young KYUNG ; Sang Pyo LEE ; Man Pyo CHUNG ; Young Hwan KIM ; Jae Ho LEE ; Yong Chul KIM ; Jong Seon RYU ; Hong Lyeol LEE ; Choon Sik PARK ; Soo Tak UH ; Young Chul LEE ; Kwan Hyung KIM ; Young Joon CHUN ; Young Bum PARK ; Dong Soon KIM ; Yongjin JEGAL ; Jin Hwa LEE ; Moo Suk PARK ; Sung Hwan JEONG
Journal of Korean Medical Science 2012;27(7):756-760
Evidence suggests that diabetes mellitus (DM) is associated with idiopathic pulmonary fibrosis (IPF). According to the new IPF guidelines, high-resolution computed tomography (HRCT) is an essential means of diagnosing IPF. We investigated the relationship between IPF and DM in patients treated between 2003 and 2007. Newly diagnosed IPF patients in large university teaching hospitals in Korea were enrolled from January 2003 to December 2007. We retrospectively analyzed 1,685 patients using the interstitial lung disease (ILD) registry. In total, 299 IPF patients (17.8%) also had DM. The mean age of our subjects was 68.0 +/- 9.4 yr. HRCT showed significantly more reticular and honeycomb patterns in IPF patients with DM than in IPF patients without DM (P = 0.014, P = 0.028, respectively). Furthermore, significantly higher incidences of hypertension, cardiovascular diseases, and other malignancies (except lung cancer) were found in IPF patients with DM than in IPF patients without DM. In conclusion, IPF patients with DM are more likely to have the usual interstitial pneumonia (UIP) pattern, including reticular and honeycomb patterns, on HRCT than are those without DM.
Aged
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Cardiovascular Diseases/epidemiology/etiology
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Diabetes Mellitus, Type 2/*complications
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Female
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Humans
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Hypertension/epidemiology/etiology
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Idiopathic Pulmonary Fibrosis/complications/*diagnosis/radiography
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Incidence
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Male
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Middle Aged
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Neoplasms/epidemiology/etiology
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Registries
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Republic of Korea/epidemiology
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Retrospective Studies
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Tomography, X-Ray Computed
5.Pulmonary Hypertension Associated with Use of Phentermine.
Woo Dae BANG ; Ji Ye KIM ; Hee Tae YU ; Sung Soo CHO ; Ji Yong JANG ; Chang Myung OH ; Boyoung JOUNG ; Hyuk Jae CHANG
Yonsei Medical Journal 2010;51(6):971-973
Weight-control drugs (known as anorexigens) such as fenfluramine have been linked with pulmonary hypertension in previous reports. In our case, a 29 year old woman was admitted for shortness of breath and was diagnosed with pulmonary hypertension. Three months ago, she had been taking phentermine for five weeks. Other factors that might have contributed to the development of pulmonary hypertension were excluded. With treatment, her symptoms improved. This is the first case that can suggest a possible connection between phenermine single medication with pulmonary hypertension. Phentermine has been considered a relatively safe drug to treat obesity, and further investigation is needed to decide the safety and dosage of phentermine.
Adult
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Antihypertensive Agents/therapeutic use
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Electrocardiography/methods
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Female
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Humans
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Hypertension, Pulmonary/*drug therapy/*etiology
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Models, Chemical
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Obesity/drug therapy
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Phentermine/*adverse effects/*therapeutic use
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Radiography, Thoracic/methods
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Safety
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Sulfonamides/therapeutic use