Chronic pulmonary thromboembolic disease

Abstract

Chronic Thromboembolic Pulmonary Hypertension (CTEPH), defined as precapillary pulmonary hypertension (PH) with right heart catheterization and imaging consistent with chronic thromboembolism, is a long-term complication of Pulmonary Embolism (PE). CTEPH defines symptomatic patients with maladaptive perfusion disorders after at least 3 months of therapeutic anticoagulation. In this setting, pulmonary hypertension results from extensive Pulmonary Artery (PA) obstruction by only organized fibrotic clots and may also be present as micro vasculopathy. Echocardiographic (ECHO) examination to determine a pulmonary surgical operation if the patient complains of anticipation and/or the risk for CTEPH is widely demonstrated (prior PE episodes, existing imaging size as index event suggestive of CTEPH, key features such as hypothyroidism and cancer), It is the preferred recognition method because of its availability and the high data value and amount of data. Patients diagnosed with CTEPH or with a strong suspicion of CTEPH should be referred to a specialist pulmonary cardiovascular clinic for further multidisciplinary diagnosis and treatment, such as Pulmonary Endarterectomy (PEA), balloon Pulmonary Angioplasty (BPA), and/or Targeted pulmonary medical therapy. In recent years, significant progress has been made in evaluating patients with sequelae after a pulmonary embolism, confirming clinical, biochemical, and hemodynamic criteria. Further work is needed to elucidate and develop appropriate standing protocols to support limited purposes and ongoing archives to ensure physical care capacity and life security.