Secondary pulmonary hypertension

Case contributed by Dr Jeremy Jones

Presentation

Previous cardiac surgery to repair an ASD. Increased shortness of breath.

Patient Data

Age: 20 years
Gender: Male
X-ray

Grossly abnormal mediastinal contour in the presence of sternotomy wires suggesting prior cardiac surgery. Of note is the enlarged pulmonary conus. There is accompanying pulmonary plethora.

There is marked enlargement of the pulmonary conus and the main pulmonary artery is wider than the aorta on the CT which mirrors the appearances on the chest radiograph.

Case Discussion

Features of pulmonary hypertension in the presence of prior cardiac surgery and ASD repair. Raised pulmonary pressures confirmed at echocardiography.

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