Korean J Leg Med.  2019 May;43(2):81-85. 10.7580/kjlm.2019.43.2.81.

Sudden Death due to Rupture of Pulmonary Trunk Aneurysm in a Patient with Eisenmenger Syndrome

  • 1Department of Pathology, Pohang Semyeong Christianity Hospital, Pohang, Korea.
  • 2Department of Forensic Medicine, School of Medicine, Kyungpook National University, Daegu, Korea. sanghan1@knu.ac.kr


Proximal pulmonary artery aneurysms and dissection are rare and life-threatening conditions, which are usually detected only during autopsy examination in cases of sudden death. These pathological entities often occur as complications of chronic pulmonary hypertension and most commonly result from pulmonary arterial hypertension associated with various congenital cardiac lesions involving left-to-right shunting. This study describes an autopsy case of a 38-year-old man who was diagnosed with Eisenmenger syndrome 5 years prior to sudden death secondary to cardiac tamponade following a ruptured pulmonary trunk aneurysm.


Eisenmenger syndrome; Sudden death; Pulmonary hypertension; Autopsy

MeSH Terms

Cardiac Tamponade
Death, Sudden*
Eisenmenger Complex*
Hypertension, Pulmonary
Pulmonary Artery


  • Fig. 1 The pulmonary trunk shows aneurysmal dilatation (arrowheads) with thrombus and is dissected circumferentially (arrows).

  • Fig. 2 The right pulmonary artery shows fatty streaks and atheromas on the intimal surface along its branches.

  • Fig. 3 The lung parenchyma shows two organizing thrombi (arrows) in the branches of the pulmonary artery.

  • Fig. 4 A large perimembranous ventricular septal defect (arrows) measuring 25 mm at its maximal diameter is seen below the pulmonary valves in the right ventricle.

  • Fig. 5 The microscopic examination of small pulmonary artery shows concentric medial hypertrophy (H&E stain, ×400).

  • Fig. 6 The microscopic examination of small pulmonary artery shows a typical plexiform lesion in the pulmonary hypertension (H&E stain, ×400).


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