A 37-year-old woman with a history of surgically repaired atrial septal defect presented with long-standing exertional chest pain and dyspnea. Laboratory tests and electrocardiography were normal, and transthoracic echocardiography showed valvular regurgitation and elevated pulmonary pressures, but limited assessment of left ventricular function. Coronary computed tomography angiography (CCTA) revealed a quadricuspid pulmonary valve (QPV), pulmonary artery aneurysm measuring 45.5 mm, and ostial compression of the left main coronary artery (LMCA), reducing the luminal diameter to 2.3 mm. This is the first report linking pulmonary artery aneurysm and LMCA compression to an underlying QPV, emphasizing the diagnostic value of CCTA.
Tekinhatun et al. (Thu,) studied this question.