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Cardiovascular Images
January 15, 2020

A Man in His 40s With Coronary-to-Pulmonary Artery Collateralizations

Author Affiliations
  • 1Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada
  • 2Department of Social and Preventive Medicine, Université Laval, Québec, Québec, Canada
  • 3Department of Medicine, University of Toronto, Toronto, Ontario, Canada
JAMA Cardiol. 2020;5(3):356. doi:10.1001/jamacardio.2019.5289

What underlying lung condition can predispose a patient to develop the coronary angiography findings shown in this article? A man in his 40s underwent cardiac catheterization for suspected chronic thromboembolic pulmonary hypertension after perfusion defects were identified on ventilation-perfusion scan results and echocardiogram results revealed a dilatation of the right-sided cardiac chambers. Right heart catheterization results demonstrated elevated mean pulmonary artery pressure (47 mm Hg) and pulmonary vascular resistance (8.9 Wood units) yet normal pulmonary capillary wedge pressure, indicating precapillary pulmonary hypertension secondary to chronic thromboembolism (World Health Organization group IV pulmonary hypertension).1

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