Patient's way from acute pulmonary embolism to chronic thromboembolic pulmonary hypertension: diagnostic and treatment options

Abstract

Сhronic thromboembolic pulmonary hypertension (CTEPH) is a serious, under - diagnosed but potentially curable complication of pulmonary embolism (PE) due to medicine advancements. Lack of specific symptoms and signs makes its diagnosis challenging, requiring clinicians to be ready to suspect its presence in patients with dyspnea of unknown origin or persistent symptoms after the pulmonary embolism event. The success of the treatment of this disease depends entirely on early diagnosis. The complexity of the differential diagnosis is due to the problematic aspects including the lack of doctors' awareness of both the pathology itself and the possibilities of its modern treatment. Recently, in our country, the problem of the availability of expert centers with sufficient experience in providing highly specialized medical care to this rather difficult category of patients who need specific therapy has become very actual. The aim of this review is to provide contemporary information about epidemiology, pathophysiology, and clinical features of treating patients with CTEPH, and also, to increase awareness of potential PE→CTEPH transformation. In the article a 4-year - period of experience of the Meshalkin National Medical Research Center on management of CTEPH patients has been presented.

Keywords

• pulmonary embolism
• chronic thromboembolic pulmonary hypertension
• pulmonary endarterectomy
• pah-specific therapy