Pulmonary atherosclerosis associated with an atrial septal defect in old age: Case report of an elderly autopsied patient

In the literature, there are few studies on atherosclerosis in the pulmonary artery in human beings, especially in aging. The aim of the study was to report the anatomic pathological aspects of an old patient who had severe pulmonary atherosclerosis associated with an atrial septal defect (ASD). The patient had marked atherosclerosis in the pulmonary trunk and its branches, probably caused by a series of hemodynamic and endothelial changes, subsequent to the ASD. The left to right shunt could have caused an increase in the blood flow and pulmonary hypertension, intensified by the vascular alterations in the region. This hypertension probably became intense to the point of reversing the direction of the shunt, from the right to the left, characterizing a probable Eisenmenger syndrome, responsible for the patient's dyspnea and cyanosis. Our study demonstrates a condition that is especially infrequent because of the patient's age of 64 years and, thus, adds to the literature.