Compression of the Left Main Bronchus Between a Descending Thoracic Aortic Aneurysm and an Enlarged Right Pulmonary Artery
Descending thoracic aortic aneurysms rarely cause tracheobronchial compression, unlike the aortic arch aneurysms in which this complication is well known. We review the case report of a patient with compression of the left-main bronchus between an enlarged right pulmonary artery and a descending thoracic aortic aneurysm. The enlarged right pulmonary artery played a significant role in the trancheobronchial compression more buy ampicillin online. This has not previously been reported.
A 76-year-old man presented to hospital in hypoxemic and hypercapneic respiratory failure. This man had a history of smoking (60-pack-years) and severe obstructive lung disease (FEVi=0.74 L, 39 percent predicted; FVC 1.64 L, 72 percent predicted). There had been a progressive decrease in exercise tolerance for 6 years such that most recently he was dyspneic when walking less than 20 feet. He had been admitted to the hospital for acute exacerbations of chronic obstructive lung disease on six occasions over the preceding 3 years. Left-sided infiltrates either in the lingula or the lower lobe were noted on three admissions. These resolved incompletely leaving evidence of residual volume loss and scarring, which was never investigated with bronchoscopy. Intubation and mechanical ventilation were required on two admissions.
In the 3 months leading up to the current admission, the patient had a weight loss of 6 kg as a result of anorexia. He complained of increasing dyspnea on mild exertion and intermittent fever. Two weeks before admission, his sputum became more purulent and increased in quantity. One week before admission, he was seen by his family physician who prescribed trimethoprim/sulfamethoxasole 160 mg/800 mg by mouth twice a day. He did not improve and was referred to the hospital for admission. At the time of admission, he was being treated with inhaled budesonide 200 fig four times daily, furosemide 40 mg by mouth every day, theophylline 300 mg by mouth twice a day, and glyburide 5 mg by mouth every day.
Category: Respiratory Symptoms
Tags: aortic aneurysm, pulmonary hypertension, tracheobronchial compression