[Chronic thrombo-embolic pulmonary hypertension]

Chronic thrombo-embolic pulmonary hypertension (CTEPH) was diagnosed in two patients, a man aged 55 years and a woman aged 54 years, who had both suffered an episode of pulmonary embolism. CTEPH is a rare but serious late complication of pulmonary embolism. If left untreated, it is a progressive disease with a poor prognosis. Pulmonary endarterectomy is the treatment of choice for CTEPH; both patients were treated successfully with this operation. In clinical practice patients are often initially misdiagnosed, due to unawareness of the condition, and are therefore subjected to a long delay before treatment. In the first patient the condition had not been recognised on CT scans. The second patient had initially been treated with psychotherapy for a suspected burn-out. All physicians involved in taking care of patients with pulmonary embolism, must be aware of this serious complication. Diagnosis and treatment of CTEPH require a high level of expertise.