scholarly journals Chronic thromboembolic pulmonary hypertension in young woman with history of caesarian section

2015 ◽  
Vol 23 (4) ◽  
pp. 232-8 ◽  
Author(s):  
Nitia A. Asbarinsyah ◽  
Rarsari S. Soerarso ◽  
Nani Hersunarti ◽  
Bambang B. Siswanto
Keyword(s):  
Pulmonary Hypertension ◽  
Medical Condition ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Caesarian Section ◽  
Pulmonary Angiography ◽  
Diagnostic Tools ◽  
Vein Thrombosis ◽  
Pulmonary Vasodilator ◽  
Thromboembolic Pulmonary Hypertension ◽  
History Of

Chronic thromboembolic pulmonary hypertension (CTEPH) is one of subgroups of pulmonary hypertension. This is a serious medical condition that severely under diagnosed. CTEPH is commonly underdiagnosed due to non specific symptoms and lack of diagnostic tools. The aim of this presentation is to discuss the etiology, risk factors, diagnosis and management of CTEPH. A 36-year-old woman presented with easily fatigue and dyspneu on effort since two years ago. The symptom occured about three months after she gave birth with caesarian section due to preeclampsia. Further history taking, physical examination, electrocardiography (ECG) and echocardiography were highly suggestive of pulmonary hypertension. No deep vein thrombosis (DVT) was found on vascular femoral sonography. It was found after the lung perfusion scintigraphy performed that she actually had CTEPH. This patient was categorized as inoperable because CT pulmonary angiography showed no thrombus. The patient got pulmonary vasodilator and oral anticoagulant for lifelong.

scholarly journals Validation of a claims-based algorithm to identify patients with chronic thromboembolic pulmonary hypertension using electronic health record data

2018 ◽  
Vol 9 (1) ◽  
pp. 204589401881477 ◽  
Author(s):  
Simon Teal ◽  
William R. Auger ◽  
Rodney J. Hughes ◽  
Dena Rosen Ramey ◽  
Kelly S. Lewis ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Gold Standard ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Administrative Claims ◽  
Electronic Health Record Data ◽  
Health Records ◽  
Record Data ◽  
Thromboembolic Pulmonary Hypertension ◽  
History Of ◽  
Electronic Health

This study aimed to validate an algorithm developed to identify chronic thromboembolic pulmonary hypertension (CTEPH) among patients with a history of pulmonary embolism. Validation was halted because too few patients had gold-standard evidence of CTEPH in the administrative claims/electronic health records database, suggesting that CTEPH is underdiagnosed.

scholarly journals Favorable Evolution of a Patient with Thromboembolic Pulmonary Hypertension

2017 ◽  
Vol 23 (2) ◽  
pp. 94-98
Author(s):  
Cristina Nedelcu ◽  
Irinel Raluca Parepa ◽  
Laura Mazilu ◽  
Andra-Iulia Suceveanu ◽  
Luminita Matei ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Young Adulthood ◽  
Primary Pulmonary Hypertension ◽  
Endothelin Receptor ◽  
Vein Thrombosis ◽  
Thromboembolic Pulmonary Hypertension ◽  
History Of ◽  
Recurrent Deep Vein Thrombosis ◽  
Deep Vein ◽  
Phosphodiesterase 5

AbstractWe present a case of severe thromboembolic pulmonary hypertension in a patient with history of recurrent deep vein thrombosis and pulmonary restrictive disease due to pulmonary and vertebral tuberculosis in young adulthood. He was considered not eligible in the National Program for Primary Pulmonary Hypertension, being referred for thoracic surgery, but he was considered unfit for thrombendarterectomy. Despite guidelines, we administered him specific medical therapy (phosphodiesterase-5 inhibitors and endothelin receptor antagonists). His clinical evolution was satisfactory, with increasing effort tolerance and decreasing need for ambulatory oxigenotherapy.

scholarly journals Association Between Anticoagulation Outcomes and Venous Thromboembolism History in Chronic Thromboembolic Pulmonary Hypertension

2021 ◽  
Vol 8 ◽  
Author(s):  
Yong-Jian Zhu ◽  
Yu-Ping Zhou ◽  
Yun-Peng Wei ◽  
Xi-Qi Xu ◽  
Xin-Xin Yan ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Venous Thromboembolism ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Prior History ◽  
Anticoagulation Treatment ◽  
Increased Risk ◽  
Thromboembolic Pulmonary Hypertension ◽  
History Of ◽  
Recurrent Vte ◽  
Potential Factors

Background: The association between anticoagulation outcomes and prior history of venous thromboembolism (VTE) in chronic thromboembolic pulmonary hypertension (CTEPH) has not been established. This study aimed to compare the efficacy and safety of anticoagulation treatment in CTEPH patients with and without prior history of VTE.Methods: A total of 333 CTEPH patients prescribed anticoagulants were retrospectively included from May 2013 to April 2019. The clinical characteristics were collected at their first admission. Incidental recurrent VTE and clinically relevant bleeding were recorded during follow-up. The Cox proportional regression models were used to identify potential factors associated with recurrent VTE and clinically relevant bleeding.Results: Seventy patients (21%) without a prior history of VTE did not experience recurrent VTE during anticoagulation. Compared to CTEPH patients without a prior history of VTE, those with a prior history of VTE had an increased risk of recurrent VTE [2.27/100 person-year vs. 0/100 person-year; hazard ratio (HR), 8.92; 95% confidence interval (CI), 1.18–1142.00; P = 0.029] but a similar risk of clinically relevant bleeding (3.90/100 person-year vs. 4.59/100 person-year; HR, 0.83; 95% CI, 0.38–1.78; P = 0.623). Multivariate Cox analyses suggested that a prior history of VTE and interruption of anticoagulation treatments were significantly associated with an increased risk of recurrent VTE, while anemia and glucocorticoid use were significantly associated with a higher risk of clinically relevant bleeding.Conclusions: This study is the first to reveal that a prior history of VTE significantly increases the risk of recurrent VTE in CTEPH patients during anticoagulation treatment. This finding should be further evaluated in prospective studies.

scholarly journals Chronic Thromboembolic Pulmonary Hypertension Medical Management

2021 ◽  
Vol 17 (2) ◽  
pp. e28-e32
Author(s):  
Ryan Logue ◽  
Zeenat Safdar
Keyword(s):  
Pulmonary Hypertension ◽  
Medical Management ◽  
Soluble Guanylate Cyclase ◽  
Pulmonary Arteries ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Standard Of Care ◽  
Pulmonary Angiography ◽  
Thromboembolic Pulmonary Hypertension ◽  
Soluble Guanylate Cyclase Stimulator

Chronic thromboembolic pulmonary hypertension (CTEPH) is a common long-term complication of pulmonary embolism characterized by thromboembolic obstruction of the pulmonary arteries, vascular arteriopathy, vascular remodeling, and ultimately pulmonary hypertension (PH). Although pulmonary endarterectomy (PEA) surgery is the standard of care, approximately 40% of patients in the international CTEPH registry were deemed inoperable. In addition to lifelong anticoagulation, the cornerstone of PH-specific medical management is riociguat, a soluble guanylate cyclase stimulator. Medical management should be started early in CTEPH patients and may be used as a bridge to PEA surgery or balloon pulmonary angiography. Medical management is indicated for inoperable CTEPH patients and patients who have recurrence of PH after PEA surgery.

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