Document Detail


Chronic thromboembolic pulmonary hypertension as a cause of dyspnoea in an older patient with a complex history.
MedLine Citation:
PMID:  20956138     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A full diagnostic work-up for patients with pulmonary hypertension (PH) is vital. Classification and diagnosis of the underlying cause is important to ensure optimal management, but may be complicated by overlapping signs and symptoms. This case study describes how a full work-up identified chronic thromboembolic PH (CTEPH) as the cause of dyspnoea in a 68-yr-old male with a history of pulmonary embolism and an original diagnosis of chronic obstructive pulmonary disease. Key indicators included decreased tricuspid annular plane systolic excursion, increased Tei index and elevated systolic pulmonary artery pressure. Multi-slice spiral chest computed tomography and pulmonary angiography showed severe chronic thromboembolic pulmonary disease, both centrally and distally. Diffusing capacity of the lung for carbon monoxide was reduced and blood gas analysis revealed a wide alveolar-arterial oxygen pressure difference, which is typical of CTEPH. The patient was eligible for pulmonary endarterectomy according to established criteria. Residual PH after surgery was successfully managed with bosentan.
Authors:
C M Kähler
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European respiratory review : an official journal of the European Respiratory Society     Volume:  18     ISSN:  1600-0617     ISO Abbreviation:  Eur Respir Rev     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2010-10-19     Completed Date:  2011-01-31     Revised Date:  2013-06-18    
Medline Journal Info:
Nlm Unique ID:  9111391     Medline TA:  Eur Respir Rev     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  170-3     Citation Subset:  IM    
Affiliation:
Dept of Internal Medicine, Medical University of Innsbruck, Austria. C.M.Kaehler@i-med.ac.at
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / therapeutic use
Chronic Disease
Dyspnea / etiology*,  radiography,  surgery
Endarterectomy
Humans
Hypertension, Pulmonary / complications*,  drug therapy,  radiography
Male
Middle Aged
Pulmonary Embolism / complications*,  radiography,  surgery
Sulfonamides / therapeutic use
Tomography, Spiral Computed
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Sulfonamides; Q326023R30/bosentan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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