Fatal Pulmonary Artery Dissection in the Setting of Aneurysm and Pulmonary Hypertension: A Case Report and Literature Review

Pulmonary artery aneurysm (PAA) with dissection is an extremely rare and highly fatal cardiovascular emergency. We present the case of a 56-year-old woman with a history of poorly controlled hypertension who developed sudden-onset chest pain and progressive dyspnea. Imaging studies revealed a giant pulmonary artery aneurysm with dissection involving the right pulmonary artery. Despite emergency management, the patient died within 3 hours of admission. We describe the diagnostic process using multimodal imaging, including contrast-enhanced CT, echocardiography, and ECG, and discuss the clinical features, pathophysiological mechanisms, and challenges in management. A comprehensive literature review contextualizes this condition's rarity, diagnostic pitfalls, and therapeutic uncertainties.