CASE REPORT

Massive pulmonary artery thrombosis with haemoptysis in adults with Eisenmenger’s syndrome: a clinical dilemma

C Broberg¹, M Ujita², S Babu-Narayan¹, M Rubens², S K Prasad¹, J S R Gibbs¹, M A Gatzoulis¹

¹ Division of Cardiology, Royal Brompton Hospital and Harefield NHS Trust, London, UK
² Department of Radiology, Royal Brompton Hospital and Harefield NHS Trust

Correspondence to:
Correspondence to:
Dr Michael A Gatzoulis
Adult Congenital Heart Disease Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; m.gatzoulis{at}rbh.nthames.nhs.uk

Although the frequency of haemoptysis in Eisenmenger’s syndrome is well recognised, the high prevalence of pulmonary artery thrombus has been newly appreciated through the growing use of non-invasive imaging. Three patients with Eisenmenger’s syndrome with haemoptysis are reported who underwent computed tomography pulmonary angiography and cardiovascular magnetic resonance. Each patient was found to have aneurysmal dilatation of the right pulmonary artery with large laminar thrombus. These cases illustrate a rising clinical problem in this special population—that is, how to treat and prevent large pulmonary artery thrombosis in the setting of haemoptysis. The authors discuss their approach to these cases and the known literature.

Abbreviations: CMR, cardiovascular magnetic resonance; CT, computed tomography; CTPA, computed tomography pulmonary angiography; VSD, ventricular septal defect

Keywords: congenital heart disease; cyanotic heart disease; Eisenmenger’s syndrome; haemoptysis; pulmonary hypertension

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