Pulmonary venous thrombosis

Case contributed by Dr Nerses Nersesyan

Presentation

A 40-year-old patient who presented with acute thoracic pain and hemoptysis was admitted to the emergency department. The patient underwent radiofrequency catheter ablation (RFCA) procedure percutaneously for atrial fibrillation six months before.

Patient Data

Age: 40
Gender: Male
X-ray

Patchy alveolar opacities can be observed in left upper and middle pulmonary fields, corresponding to the Left Upper Lobe (LUL), accompanied with ipsilateral pleural effusion. A prominent left hilum is noted.

CT

Stenosis/thrombosis at the ostium of the left superior pulmonary vein (PV). Note thrombosis of veins draining the left upper lobe (LUL). Peripherally distributed left upper lobe consolidations with associated septal thickening and ground glass opacities in LUL, compatible with pulmonary infarction. 

Case Discussion

The incidence of PV stenosis after RFCA varies from 1-10% and can occur within days to months after the procedure.

When severe, PV stenosis can result in complete thrombosis of the PV resulting in venous infarcts, pulmonary veno-occlusive disease, and pulmonary artery hypertension.

PV stenosis may be treated with balloon dilatation with or without stent placement.

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Case information

rID: 54842
Case created: 1st Aug 2017
Last edited: 27th Nov 2017
Systems: Chest, Cardiac
Inclusion in quiz mode: Included

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