Pulmonary hypertension and patent ductus arteriosus in an 82-year-old female patient

An 82-year-old female patient with a history of deep vein thrombosis presented with progressive dyspnea. Echocardiogram demonstrated significant pulmonary hypertension and patent ductus arteriosus (PDA). There was considerable debate regarding the role of PDA in the patientʹs pulmonary hypertension. The patient died of heart failure a few months later. Autopsy demonstrated extensive chronic pulmonary thromboembolic disease. Pulmonary thromboemboli continue to be a diagnostic challenge despite modern diagnostic modalities. Autopsy continues to play a role in investigating unexplained clinical findings and in determining cause of death.