Chronische trombo-embolische pulmonale hypertensie

Translated title of the contribution: Chronic thromboembolic pulmonary hypertension: recognition, diagnosis and treatment

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

- Chronic thromboembolic pulmonary hypertension (CTEPH), characterised by pulmonary hypertension and persistent perfusion defects despite adequate anticoagulation, causes significant morbidity and mortality.- Persistent dyspnoea after acute pulmonary embolism is frequent and an indication for additional diagnostics. Only a minority of these patients develop CTEPH.- Echocardiography and perfusion scintigraphy are the cornerstone of diagnostics when suspecting CTEPH. Right-heart catheterisation and pulmonary angiography should confirm the diagnosis.- The diagnostic phase is preferably carried out in an expert centre in order to optimise the diagnosis and choose the optimal treatment for each individual patient.- Treatment of patients with CTEPH is a multidisciplinary team effort.- Pulmonary endarterectomy is the only potentially curative treatment; perioperative mortality is less than 5% in experienced centres. Inoperable patients can be treated with medication that specifically targets pulmonary arterial hypertension, but a survival benefit has not yet been shown for this medication.- Balloon pulmonary angioplasty has recently become available in the Netherlands as a treatment option, but the exact role of this new technique in the treatment of patients with CTEPH still needs to be investigated.

Original languageDutch
Pages (from-to)D1597
JournalNederlands Tijdschrift voor Geneeskunde
Volume161
Issue number0
Publication statusPublished - 2017

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