Pulmonary artery dissection (PAD) is a rare diagnosis that is often made postmortem in patients with pulmonary hypertension. It can be visualized by echocardiography, computed tomography, or magnetic resonance imaging. We present a patient with emphysematous chronic obstructive pulmonary disease and secondary pulmonary hypertension in whom a PAD appeared like a mediastinal mass on computed tomography. The diagnosis was made at autopsy. We think that physicians should consider the possibility of a PAD in patients with chronic pulmonary hypertension who present with dyspnea and chest pain.
