Unilateral Pulmonary Artery Agenesis

Abstract

A 46-year-old female patient presented at the emergency department with hemoptysis of unknown cause. Past medical history was significant for pulmonary hypertension with Eisenmenger syndrome due to a patent ductus arteriosus that had been diagnosed in childhood. Additionally, mild asthma was reported. Except for mild dyspnea and coughing, the patient was in good general condition and did not show any signs of respiratory infection. Abdominal hysterectomy had been performed due to a uterine myoma 1 year before. Physical examination showed differential central cyanosis with clubbing of the toes but not of the fingers. Cardiac auscultation revealed an accentuated second heart sound at the base and a 2/6 continuous machinery murmur at the upper left sternal region. On lung auscultation, left-sided basilar rales were noted, but no wheezing. Pertinent laboratory results were unremarkable except for microcytic, hypochromic polycythemia (red blood cells: 7.96×106/μL, mean corpuscular volume 74.7 fL, mean corpuscular hemoglobin 23.6 pg/cell). Blood oxygen …