A case of chronic thromboembolic pulmonary hypertension

  • Lucio Brugioni | luciob2362@gmail.com Internal Medicine and Critical Area Unit, Policlinico Modena, Italy.
  • Eleonora Mazzali Emergency Medicine, University of Modena and Reggio Emilia, Italy.
  • Chiara Catena Emergency Medicine, University of Modena and Reggio Emilia, Italy.
  • Francesca Mori Emergency Medicine, University of Modena and Reggio Emilia, Italy.
  • Francesco Benatti Emergency Medicine, University of Modena and Reggio Emilia, Italy.
  • Francesca de Niederhausern Internal Medicine and Critical Area Unit, Policlinico Modena, Italy.
  • Daniela Vivoli Internal Medicine and Critical Area Unit, Policlinico Modena, Italy.
  • Andrea Borsatti Internal Medicine and Critical Area Unit, Policlinico Modena, Italy.
  • Beatrice Aramini Division Thoracic Surgery, Policlinico Modena, Italy.
  • Elisa Romagnoli Internal Medicine and Critical Area Unit, Policlinico Modena, Italy.

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially fatal complication of pulmonary embolism (PE). Organized thrombus in the pulmonary artery causes a chronic obstruction, leading to a vascular system remodeling, an increase of pulmonary vascular resistance and a chronic pulmonary hypertension. Epidemiology is mostly unknown due to the difficult diagnostic process that often leads to a late diagnosis: findings of persistent pulmonary hypertension (PH), despite correct treatment of PE, lead to the diagnostic suspect. The first choice treatment is pulmonary endarterectomy (PEA) associated with lifelong anticoagulant therapy with vitamin K antagonist. We present the case of a 53-year-old male affected by dyspnea for months, admitted to a sub-intensive care unit for intermediate low-risk PE; echocardiography showed signs of PH persisting after anticoagulant therapy; after 2 months of specific treatment the diagnosis of CTEPH was confirmed and the patient was successfully treated with PEA.

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Published
2020-06-17
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Section
Case Reports
Keywords:
Chronic thromboembolic pulmonary hypertension, pulmonary embolism, pulmonary endarterectomy, echocardiography, anticoagulant therapy.
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How to Cite
Brugioni, L., Mazzali, E., Catena, C., Mori, F., Benatti, F., de Niederhausern, F., Vivoli, D., Borsatti, A., Aramini, B., & Romagnoli, E. (2020). A case of chronic thromboembolic pulmonary hypertension. Italian Journal of Medicine, 14(2), 102-105. https://doi.org/10.4081/itjm.2020.1250

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