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A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
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Chronic Obstructive Pulmonary Disease, or COPD, is a long-term condition marked by persistent and only partially reversible airflow limitation. It involves two overlapping conditions—chronic bronchitis and emphysema—which often co-appear but differ in dominant symptoms and underlying mechanisms.Chronic Bronchitis FeaturesChronic bronchitis presents with a persistent productive cough and thick, sometimes purulent mucus due to airway inflammation, enlarged mucus glands, and goblet...
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Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
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Chronic obstructive pulmonary disease is a common, preventable, and treatable respiratory disorder characterized by persistent symptoms and progressive airflow limitation. This limitation results from a combination of small-airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), both driven by chronic inflammation from exposure to harmful particles or gases.The disease includes two main pathological entities: emphysema, marked by destruction of alveolar walls and...
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Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
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Chronic thromboembolic pulmonary hypertension.

Nick H Kim1, Marion Delcroix2, David P Jenkins3

  • 1University of California San Diego, La Jolla, California.

Journal of the American College of Cardiology
|December 21, 2013
PubMed
Summary

Recent advancements in chronic thromboembolic pulmonary hypertension (CTEPH) include updated diagnostic guidelines and new treatment data. Pulmonary endarterectomy remains the primary treatment for operable CTEPH, with expanded options for select patients.

Keywords:
ACPCTCTEPHCTPADHCAECMOMRIPAHPAPPEAPHPTPAPVRRCTsVQantegrade cerebral perfusionchronic thromboembolic pulmonary hypertensioncomputed tomographycomputed tomography pulmonary angiogramdeep hypothermic circulatory arrestextracorporeal membrane oxygenationmagnetic resonance imagingpercutaneous transluminal pulmonary angioplastypulmonary angiogrampulmonary arterial hypertensionpulmonary artery pressurepulmonary endarterectomypulmonary hypertensionpulmonary vascular resistancerandomized controlled trialsventilation/perfusionventilation/perfusion scan

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Area of Science:

  • Cardiology
  • Pulmonology
  • Vascular Medicine

Background:

  • Significant progress in understanding and managing chronic thromboembolic pulmonary hypertension (CTEPH) has occurred since 2008.
  • Technological and clinical data advancements are refining diagnostic and therapeutic strategies.

Purpose of the Study:

  • To provide an overview of key developments in CTEPH presented at the 2013 World Symposium on Pulmonary Hypertension.
  • To highlight updated guidance on diagnosis and treatment of CTEPH.

Main Methods:

  • Review of emerging clinical data and technological advances.
  • Analysis of international treatment practices and long-term outcomes.
  • Evaluation of data from medical therapy trials and percutaneous pulmonary angioplasty case series.

Main Results:

  • Updated guidelines aim for earlier and improved recognition and diagnosis of CTEPH.
  • New data offer insights into international treatment variations and outcomes with or without pulmonary endarterectomy.
  • Expanded evidence supports alternative treatments, including medical therapy and percutaneous pulmonary angioplasty for specific CTEPH patients.

Conclusions:

  • Pulmonary endarterectomy is confirmed as the gold standard for operable CTEPH.
  • The field has seen substantial progress in diagnostic accuracy and therapeutic options for CTEPH.
  • International collaboration has enhanced the understanding of CTEPH management and outcomes.