A 35-year old man with dyspnea on exertion, history of acute pulmonary embolism and ischaemic stroke

Abstract

We present a case of a 35-year old man with a history of an acute pulmonary embolism and ischaemic stroke, who after several weeks of adequate antithrombotic treatment experienced functional deterioration with severe dyspnea and haemoptysis. Detailed evaluation reveled chronic thromboembolic pulmonary hypertension, deep vein thrombosis of his right thigh and patent foramen ovale. No laboratory signs of a hypercoagulable conditions were found. After through assessment the patient was referred for pulmonary endarterectomy and patent foramen ovale closure. Both procedures were performed successfully with the significant improvement in patient’s clinical status. Patient remained clinically stable with no signs of right ventricle dysfunction in the follow-up. This article provides details regarding etiopathogenesis, clinical features and diagnostic evaluation of chronic thromboembolic pulmonary hypertension related to an acute pulmonary embolism. It covers the latest guidelines for screening and therapy as well as information regarding innovations in health care, and social care. JRCD 2012; 1: 24–29 Key words: Pulmonary embolism; Chronic thromboembolic pulmonary hypertension; Pulmonary endarterectomy