Chronic thromboembolic pulmonary hypertension and the post-pulmonary embolism (PE) syndrome

Over a third of patients surviving acute pulmonary embolism (PE) will experience long-term cardiopulmonary limitations. Persistent thrombi, impaired gas exchange, and altered hemodynamics account for aspects of the postpulmonary embolism syndrome that spans mild functional limitations to debilitatin...

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Bibliographic Details
Published in:Vascular Medicine 2023-08, Vol.28 (4), p.348-360
Main Authors: Yuriditsky, Eugene, Horowitz, James M, Lau, Joe F
Format: Article
Language:English
Subjects:
Angioplasty
Angioplasty, Balloon
Balloon treatment
Chronic Disease
Dyspnea
Embolism
Embolisms
Endarterectomy
Epidemiology
Gas exchange
Hemodynamics
Humans
Hypertension
Hypertension, Pulmonary - diagnosis
Hypertension, Pulmonary - etiology
Hypertension, Pulmonary - therapy
Pathophysiology
Patients
Pulmonary Embolism - complications
Pulmonary Embolism - diagnosis
Pulmonary Embolism - therapy
Pulmonary embolisms
Respiration
Syndrome
Thromboembolism
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Summary:Over a third of patients surviving acute pulmonary embolism (PE) will experience long-term cardiopulmonary limitations. Persistent thrombi, impaired gas exchange, and altered hemodynamics account for aspects of the postpulmonary embolism syndrome that spans mild functional limitations to debilitating chronic thromboembolic pulmonary hypertension (CTEPH), the most worrisome long-term consequence. Though pulmonary endarterectomy is potentially curative for the latter, less is understood surrounding chronic thromboembolic disease (CTED) and post-PE dyspnea. Advances in pulmonary vasodilator therapies and growing expertise in balloon pulmonary angioplasty provide options for a large group of patients ineligible for surgery, or those with persistent postoperative pulmonary hypertension. In this clinical review, we discuss epidemiology and pathophysiology as well as advances in diagnostics and therapeutics surrounding the spectrum of disease that may follow months after acute PE.
ISSN:1358-863X
1477-0377
DOI:10.1177/1358863X231165105