CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION AS A CAUSE OF DYSPNEA IN A 78-YEAR OLD MAN WITH HISTORY OF DEEP VENOUS THROMBOSIS AND PERMANENT ATRIAL FIBRILLATION – A CASE REPORT AND REVIEW OF LITERATURE
Abstract:
Chronic thromboembolic pulmonary hypertension (CTEPH) results from inadequate
recanalization of the pulmonary arteries as a consequence of their occlusion by thromboembolic
material; it represents a cause of severe pulmonary hypertension, being associated with significant
morbidity and mortality. CTEPH 2-year incidence is 0.1–9.1% after an acute pulmonary embolism.
Complete diagnostic work-up in patients with CTEPH is important for an optimal management.
Transthoracic echocardiography, multidetector CT pulmonary angiography and digital subtraction
pulmonary angiography are useful tools for the diagnosis and follow-up of CTEPH. We present a case
of a 78 y.o. man with dyspnoea, previous diagnostic of COPD and right heart failure, permanent atrial
fibrillation and bilateral deep venous thrombosis in which a well-oriented work-up identified CTEPH as
the cause of dyspnoea. Pulmonary endarterectomy is the treatment of choice for CTEPH when thrombi
are surgically accessible. In inoperable cases, optimal medical treatment and interventional treatment
are considered.
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