A 41-year-old man visited our institution due to mild atypical chest discomfort. Results of a 12-lead surface ECG showed a normal sinus rhythm with a heart rate of 51 beats/min. A chest X-ray showed a bulging contour of the left pulmonary hilum and inactive tuberculosis in the right upper lung. The patient denied having any systemic disease in the past, except old inactive tuberculosis in the right upper lung.
Transthoracic echocardiography revealed normal-sized cardiac chambers and normal left ventricular systolic function. Cardiac ECG-gated 64-section MDCT was planned for further evaluation. MDCT showed no significant coronary artery stenosis. However, dilatation of the pulmonary artery trunk was seen ( Fig. 1 ) and the pulmonary valve showed four cusps of similar size, with a deficit of central coaptation, probably secondary to annular dilatation ( Fig. 2 and Video 1 ). No other congenital heart anomalies were identified by MDCT. Medical treatment alone controlled his symptoms and he was discharged.
