A systemic arterial-pulmonary arterial shunt mimicking a pulmonary embolism on CT pulmonary angiogram
We report the case of a middle-aged woman on a background of severe respiratory disease who presented with hemoptysis. Investigations with CT pulmonary angiogram showed evidence of a large pulmonary arterial filling defect which was initially treated as a pulmonary embolism. However, despite being a...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043323001255 |
| _version_ | 1797854529403748352 |
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| author | Saeideh Toupchiani, MBBS, BSc Shady Hegab, MBBS, MSc, MBA Dur-E-Sameen Rana, MBBS, MRCP, FRCR Adam Ainley, MBBS, MRCP, BSc |
| author_facet | Saeideh Toupchiani, MBBS, BSc Shady Hegab, MBBS, MSc, MBA Dur-E-Sameen Rana, MBBS, MRCP, FRCR Adam Ainley, MBBS, MRCP, BSc |
| author_sort | Saeideh Toupchiani, MBBS, BSc |
| collection | DOAJ |
| description | We report the case of a middle-aged woman on a background of severe respiratory disease who presented with hemoptysis. Investigations with CT pulmonary angiogram showed evidence of a large pulmonary arterial filling defect which was initially treated as a pulmonary embolism. However, despite being anticoagulated, she experienced ongoing hemoptysis. Further imaging several days later using aortic phase CT confirmed that the filling defect was a false positive; the artifact was due to retrograde filling from a systemic arterial-pulmonary arterial shunt and anticoagulation was stopped. Although PE is the most common cause of filling defects, this case suggests that in the setting of patients with chronic inflammatory parenchymal pulmonary disease, clinicians should consider alternative causes such as systemic arterial-pulmonary arterial shunts. |
| first_indexed | 2024-04-09T20:08:37Z |
| format | Article |
| id | doaj.art-548e7a22de2e40aba86da043423bdcda |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-04-09T20:08:37Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-548e7a22de2e40aba86da043423bdcda2023-04-01T08:46:22ZengElsevierRadiology Case Reports1930-04332023-05-0118519051908A systemic arterial-pulmonary arterial shunt mimicking a pulmonary embolism on CT pulmonary angiogramSaeideh Toupchiani, MBBS, BSc0Shady Hegab, MBBS, MSc, MBA1Dur-E-Sameen Rana, MBBS, MRCP, FRCR2Adam Ainley, MBBS, MRCP, BSc3Department of Medicine, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UK; Corresponding author.Department of Radiology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UKDepartment of Radiology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UKDepartment of Respiratory Medicine, Barking, Havering and Redbridge University Hospitals NHS Trust, London, UKWe report the case of a middle-aged woman on a background of severe respiratory disease who presented with hemoptysis. Investigations with CT pulmonary angiogram showed evidence of a large pulmonary arterial filling defect which was initially treated as a pulmonary embolism. However, despite being anticoagulated, she experienced ongoing hemoptysis. Further imaging several days later using aortic phase CT confirmed that the filling defect was a false positive; the artifact was due to retrograde filling from a systemic arterial-pulmonary arterial shunt and anticoagulation was stopped. Although PE is the most common cause of filling defects, this case suggests that in the setting of patients with chronic inflammatory parenchymal pulmonary disease, clinicians should consider alternative causes such as systemic arterial-pulmonary arterial shunts.http://www.sciencedirect.com/science/article/pii/S1930043323001255Systemic arterial-pulmonary arterial shuntPulmonary embolismCTPACTAFilling defectHemoptysis |
| spellingShingle | Saeideh Toupchiani, MBBS, BSc Shady Hegab, MBBS, MSc, MBA Dur-E-Sameen Rana, MBBS, MRCP, FRCR Adam Ainley, MBBS, MRCP, BSc A systemic arterial-pulmonary arterial shunt mimicking a pulmonary embolism on CT pulmonary angiogram Radiology Case Reports Systemic arterial-pulmonary arterial shunt Pulmonary embolism CTPA CTA Filling defect Hemoptysis |
| title | A systemic arterial-pulmonary arterial shunt mimicking a pulmonary embolism on CT pulmonary angiogram |
| title_full | A systemic arterial-pulmonary arterial shunt mimicking a pulmonary embolism on CT pulmonary angiogram |
| title_fullStr | A systemic arterial-pulmonary arterial shunt mimicking a pulmonary embolism on CT pulmonary angiogram |
| title_full_unstemmed | A systemic arterial-pulmonary arterial shunt mimicking a pulmonary embolism on CT pulmonary angiogram |
| title_short | A systemic arterial-pulmonary arterial shunt mimicking a pulmonary embolism on CT pulmonary angiogram |
| title_sort | systemic arterial pulmonary arterial shunt mimicking a pulmonary embolism on ct pulmonary angiogram |
| topic | Systemic arterial-pulmonary arterial shunt Pulmonary embolism CTPA CTA Filling defect Hemoptysis |
| url | http://www.sciencedirect.com/science/article/pii/S1930043323001255 |
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