X RAY

1. IMAGE OF THE WEEK
-PROF.Dr.VASANTHI
UNIT

2. History
55 yr female came with complaints of
 Low grade fever for 5 days
 H/o fall 5 days back
 No h/o LOC / seizures/ ENT bleed after fall
 Complaints of drowsiness for 3 days
 loss of consciousness for 1 day
 Pt is a known case of filariasis from 12 yrs of
age , on regular treatment

3. Examination
 Vitals stable
 GCS 6/15
 Cvs – palpable thrill in left parasternal 2,3, 4,
intercostal space
s1 s2 heard
pansystolic murmur present in
pulmonary area
Rs – occasional crepts

19. DIFFERENTIAL DIAGNOSIS
 Aortic aneurysms
 Mediastinal mass like teratomas, lymphoma
 Congenital cystic lesions like
bronchogenic cyst and pericardial cysts,
 Dilated pulmonary artery
 Anterior or posterior chest wall lesions

20.  ECHO
Main pulmonary artery grossly dilated 8 cm
Hypokinesia of distal 2/3 of IVS
Moderate to severe pulmonary
regurgitation
mild LV dysfunction
no evidence of pulmonary hypertension
RA / RV not dilated

21.  ECHO IMPRESSION
 Idiopathic dilation of main pulmonary artery
 Severe pulmonary regurgitation
 Mod LV systolic dysfunction
 Ef 44 %
 Suggested – CT coronary angiography

22. ECG

23. CT CHEST

24. PECULIARITY
 Idiopathic dilatation of the pulmonary artery (
IDPA ) is a rare anomaly , which usually has a
benign course
 Usually detected fortuitously on chest x ray
 It is a diagnosis of exclusion