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Chronic persistent pulmonary embolism. Report of three cases
The American Journal of Medicine
|November 1, 1980
Summary
Chronic persistent pulmonary occlusion after acute pulmonary embolism is rare, especially in patients on anticoagulants. Long-term anticoagulation prevented recurrence and symptom progression in three cases, highlighting the need for identification and follow-up.
Area of Science:
- Cardiology
- Pulmonology
- Vascular Medicine
Background:
- Nonresolution of acute pulmonary embolism leading to chronic persistent pulmonary occlusion is uncommon.
- Documentation in patients receiving anticoagulants is particularly sparse.
- This study investigates three such cases with long-term follow-up.
Observation:
- Patients presented with mild to moderate dyspnea on exertion.
- Resting pulmonary artery pressures were normal, but two patients showed exercise-induced pulmonary hypertension.
- One patient experienced reocclusion after successful thromboendarterectomy due to in situ thrombosis.
Findings:
- Long-term anticoagulant therapy prevented clinical recurrence or symptom progression in all three patients.
- Despite initial treatment, one patient had reocclusion after surgery.
- No further embolization or worsening of symptoms was observed during up to seven years of follow-up.
Implications:
- Chronic persistent pulmonary embolism requires identification and long-term patient monitoring.
- Therapeutic strategies should focus on preventing recurrent embolization.
- Pulmonary thromboendarterectomy is a viable option for select patients with chronic pulmonary occlusion.