Pulmonary arterial dissection
Pulmonary arterial dissection is extremely rare but can be a fatal situation. Only a handful of cases have been described in live patients.
It is mostly described in those with chronic pulmonary arterial hypertension.
It is usually seen involving the main pulmonary trunk, which is the affected site in 80% (usually without involvement of its branches) 5.
The condition usually manifests with cardiogenic shock sudden death 4.
CT, MRA and echocardiography will demonstrate the intimal flap. Gated CT scans can be useful in assessment.
A potential pitfall is a pseudoflap due to motion artefact from aortic and cardiac motion. The presence of a similar pseudoflap in the aorta or superior vena cava would suggest that the finding is an artefact.
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