Pulmonary Artery Stenosis in a Patient with Prior Histoplasmosis and the Discovery of Complications

Jeffrey C. Songster, Haiying Liu, Tara R. Brakke, Rebecca A. Aron

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Pulmonary hypertension (PH) results from varied etiologies, leading to progressive symptoms and limiting physical activity and quality of life, with associated morbidity and mortality. External compression of the pulmonary artery (PA) is a rare cause of PH and may give the clinician cause to investigate compression of nearby structures. In this E-Challenge, the authors present a case of PA stenosis in a patient with prior histoplasmosis scheduled for left PA stenting. However, because the pulmonary veins were not well-visualized on chest computed tomography, the anesthesia team performed a perioperative transesophageal echocardiogram (TEE) to help differentiate the causes of PH. TEE revealed external compression of the pulmonary veins. This case highlights the value of pathophysiologic understanding, preoperative planning, and the effect of echocardiography on clinical management and patient safety. In this case, TEE prevented possible morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)832-834
Number of pages3
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume34
Issue number3
DOIs
StatePublished - Mar 2020

Keywords

  • fibrosing mediastinitis
  • histoplasmosis
  • perioperative transesophageal echocardiography
  • pulmonary artery stenosis
  • pulmonary hypertension
  • pulmonary vein stenosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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