Abstract
We report a rare case of a 24-year-old male with a rare anatomic variant
of patent ductus arteriosus (PDA). The patient presented with symptoms
of productive cough with recurrent and severe bouts of hemoptysis and
grade I dyspnea. There were no prior episodes reported. The patient was
vitally stable with bilateral clubbing. On cardiopulmonary auscultation,
a prominent parasternal heave, loud P2, and right lung crepitus were
noted. A complete blood count revealed an elevated hemoglobin and RBC
count. An electrocardiogram (ECG) revealed sinus tachycardia and RV
strain. ECHO confirmed these findings as dilated right atrium (RA) and
right ventricle (RV), mild tricuspid valve regurgitation (TR), and
severe pulmonary hypertension were noted. Computerized tomography (CT)
of the chest demonstrated multiple ground glass opacities, right lung
consolidation, and volume loss suggestive of right-sided pneumonia with
atelectasis. CT also proved the presence of patent ductus arteriosus and
an anomalous origin of the right pulmonary artery from the right
ascending aorta, causing compression of the right main bronchus. We show
the clinical and radiological findings and discuss the implications and
approach to this rare congenital cardiovascular malformation, as well as
how a patient-centered approach is necessary for its management.