• Sidhi Laksono Faculty of Medicine, Universitas Muhammadiyah Prof Dr Hamka, Tangerang. Department of Cardiology and Vascular Medicine, Pertamina Central Hospital, South Jakarta, Indonesia
  • Hillary Kusharsamita Pertamina Central Hospital, South Jakarta, Indonesia



Chronic Thromboembolic Pulmonary Hypertension, Computed Tomography Pulmonary Angiography, Diagnosis, Pulmonary Embolism


Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a pulmonary embolism (PE) complication that is a primary cause of pulmonary hypertension (PH) and may lead to right heart failure and significant mortality especially when left untreated. Although CTEPH is the only cause of PH that is curable without needing to resort to lung transplant, it is often misdiagnosed due to the absence of diagnostic instruments and the absence of specific presenting symptoms. This also complicates the process of distinguishing between acute thromboembolic disease and the acute embolic event worsening of undiscovered CTEPH. Objective A better understanding of CTEPH is crucial, therefore we discuss a diagnosis rare case of CTEPH. Case Description A 44-year-old man presenting with syncope and chest discomfort who had no previous episodes of acute PE. Conclusion Computed Tomography Pulmonary Angiography (CTPA) is a significant test for identifying CTPEH. Oral anticoagulants may provide patients with CTEPH a safe and beneficial life-long treatment.

Author Biography

Hillary Kusharsamita, Pertamina Central Hospital, South Jakarta



Gall H, Hoeper MM, Richter MJ, Cacheris W, Hinzmann B, et al. An epidemiological analysis of the burden of chronic thromboembolic pulmonary hypertension in the USA, Europe and Japan. Eur Respir Rev. 2017;26(143). doi: 10.1183/16000617.0121-20162.

McNeil K, Dunning J. Chronic thromboembolic pulmonary hypertension (CTEPH). Heart. 2007;93(9):1152. PMID: 17699182

Kulkarni SK, Bhairappa S, Bishnoi A, Surhonne PS. Case Report: Chronic thromboembolic pulmonary hypertension: an enigma. BMJ Case Rep. 2018. doi: 10.1136/bcr-2018-225764

Pepke-Zaba J, Delcroix M, Lang I, Mayer E, Jansa P, Ambroz D, et al. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation. 2011;124(18):1973–81. doi: 10.1161/CIRCULATIONAHA.110.015008

Dong C, Zhou M, Liu D, Long X, Guo T, Kong X. Diagnostic Accuracy of Computed Tomography for Chronic Thromboembolic Pulmonary Hypertension: A Systematic Review and Meta-Analysis. PLoS One. 2015;10(4). doi: 10.1371/journal.pone.0126985

Asbarinsyah NA, Soerarso RS, Hersunarti N, Siswanto BB. Chronic thromboembolic pulmonary hypertension in young woman with history of caesarian section. Medical Journal of Indonesia. 2014 ;23(4):232–8.doi: 10.13181/mji.v23i4.1067

Kim NH, Delcroix M, Jais X, Madani MM, Matsubara H, Mayer E, et al. Chronic thromboembolic pulmonary hypertension. Eur Respir J. 2019;53(1). doi: 10.1183/13993003.01915-2018

De Perrot M, Granton J, Fadel E. Pulmonary hypertension after pulmonary emboli: an underrecognized condition. CMAJ?: Canadian Medical Association Journal. 2006;174(12):1706. doi: 10.1183/13993003.01915-2018

Topy?a-Putowska W, Tomaszewski M, Wysoki?ski A, Tomaszewski A. Echocardiography in Pulmonary Arterial Hypertension: Comprehensive Evaluation and Technical Considerations. J Clin Med. 2021. doi: 10.3390/jcm10153229

Piazza G, Goldhaber SZ. Chronic thromboembolic pulmonary hypertension. N Engl J Med. 2011;364(4):351–60. doi: 10.1056/NEJMra091020

Patel N, Hyder SN, Michaud E, Moles V, Agarwal PP, Rosenfield K, et al. Interventional Imaging Roadmap to Successful Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension. Journal of the Society for Cardiovascular Angiography & Interventions. 2022. doi: 10.1016/j.jscai.2022.100429

Sznajder M, Dzikowska-Diduch O, Kurnicka K, Roik M, Wretowski D, Pruszczyk P, et al. Increased systemic arterial stiffness in patients with chronic thromboembolic pulmonary hypertension. Cardiol J. 2020;27(6):742–8.

Roik M, Wretowski D, Kostrubiec M, Dzikowska-Diduch O, Labyk A, Irzyk K, et al. High prevalence of severe coronary artery disease in elderly patients with non-operable chronic thromboembolic pulmonary hypertension referred for balloon pulmonary angioplasty. Postepy w Kardiologii Interwencyjnej. 2016;12(4):355–9.




Citation Check