Abstract
Pulmonary hypertension due to chronic pulmonary thromboembolism is frequently underdiagnosed and has a very poor prognosis if untreated. When the presence of central pulmonary artery thrombus is confirmed, thromboendarterectomy is the treatment of choice, with very good results. We report a 28 years old male with two previous episodes of deep venous thrombosis (DVT) who was admitted due to 8 months of progressive shortness of breath and a syncope. He underwent a CT pulmonary angiogram and an echocardiogram. Severe pulmonary hypertension was confirmed, secondary to a chronic pulmonary thromboembolism with an overlapped acute component. He received systemic thrombolysis with partial thrombus disappearance. Therefore a pulmonary thromboendarterectomy was performed and an inferior vena cava filter was placed. The patient was discharged with marked improvement in his functional capacity.
Highlights
Pulmonary hypertension due to chronic pulmonary thromboembolism is frequently underdiagnosed and has a very poor prognosis if untreated
We report a 28 years old male with two previous episodes of deep venous thrombosis (DVT) who was admitted due to 8 months of progressive shortness of breath and a syncope
El tromboembolismo pulmonar (TEP) crónico es una condición actualmente subdiagnosticada, que requiere de un alto índice de sospecha para su correcto diagnóstico, pues el tratamiento quirúrgico, indicado oportunamente, tiene muy buenos resultados
Summary
Pulmonary hypertension due to chronic pulmonary thromboembolism is frequently underdiagnosed and has a very poor prognosis if untreated. Un ecocardiograma transtorácico mostró hipertrofia ventricular derecha con sospecha de trombo en aurícula derecha y una presión sistólica de arteria pulmonar (PSAP) de 70 mmHg. Los diagnósticos de ingreso fueron TEP agudo sobre crónico, HTP secundaria severa e insuficiencia cardíaca derecha, planteándose además una trombofilia.
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