Diagnosing Chronic thromboembolic pulmonary hypertension

Go to: Chronic thromboembolic pulmonary hypertension (CTEPH)

Select Diagnosis on the left.

Making the diagnosis:
-suspect chronic thromboembolic pulmonary hypertension in patients with(1, 2)
-symptoms of progressive dyspnea on exertion and exercise intolerance
-pulmonary hypertension and history compatible with, but not limited
to, pulmonary embolism
-unexplained pulmonary hypertension
-diagnosis of chronic thromboembolic pulmonary hypertension typically includes
all of the following(1)
-pulmonary hypertension as demonstrated by transthoracic
echocardiography (TTE) and confirmed by right heart catheterization
-systolic pulmonary artery pressure > 40 mm Hg, and mean pulmonary
artery pressure > 25 mm Hg at rest
-pulmonary vascular resistance > 3 Wood units (240 dynes-second-cm-5)
-abnormal pulmonary angiogram or ventilation-perfusion (V/Q) scan showing
persistent obstruction of main, lobar, segmental, or subsegmental pulmonary
arteries despite 3 months of therapeutic anticoagulation
-exclusion of other causes of pulmonary hypertension including exclusion of
left-sided heart disease by pulmonary capillary wedge pressure < 15 mm Hg

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