A patient with ventricular septal defect and pulmonary arterial hyperten sion (Eisenmenger's syndrome) associated with aortic coarctation with fol low-up for 19 years, and with rupture of an aneurysmatic pulmonary artery is described. An incident of extreme fright with a possible transient systemic hypertension may have precipitated the dissection of the pulmonary arterial intima and the rupture.
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