Chronic thromboembolic pulmonary hypertension in young woman with history of caesarian section

Asbarinsyah, Nitia A.; Soerarso, Rarsari; Hersunarti, Nani; Siswanto, Bambang Budi

doi:10.13181/mji.v23i4.1067

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…Anterior precordial leads often show T wave inversion, which represents repolarization irregularities associated with right ventricular hypertrophy. 6 Although there may not be a consistent correlation between ECG findings and the severity of pulmonary PH, a study involving 47 patients reported that a R wave amplitude in V1 greater than 1.2 mV or an R/SV1 ratio exceeding 7 can indicate a pulmonary artery systolic pressure surpassing 90 mm Hg. The sensitivity of this indicator was found to be 94%, while the specificity was 47%.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, Echocardiography is helpful because it may identify secondary conditions including left-sided heart disease, valvular abnormalities, chamber mass, or intracardiac shunt. 6,9 A diagnosis of CTEPH was made after the patient's echocardiogram indicated positive McConnell, positive D-Shaped left ventricle, moderate PH with a mPAP of 46 mmHg. Growing research has examined the CTPA's diagnostic accuracy for CTEPH.…”

Section: Discussionmentioning

confidence: 99%

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Chronic Thromboembolic Pulmonary Hypertension: How to Diagnose? A Case Report

Laksono,

Kusharsamita

2023

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Chronic Thromboembolic Pulmonary Hypertension: How to Diagnose? A Case Report

Laksono,

Kusharsamita

2023

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“…A ventilation/perfusion scan (V/Q) is an important test for differentiating IPAH from chronic thromboembolic PH [ 14 ]. Underutilization of V/Q scans during the screening of PH patients might lead to misdiagnosis of PAH [ 14 ].…”

Section: Diagnosis Of Pah In Indonesia and Guideline Implementationmentioning

confidence: 99%

Pulmonary Arterial Hypertension in Indonesia: Current Status and Local Application of International Guidelines

et al. 2021

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Recent advances in the diagnosis and management of pulmonary arterial hypertension (PAH) have led to a significant improvement in the outcomes for patients with PAH. However, prompt and accurate diagnosis of PAH remains an unmet challenge due to lack of awareness and lack of meticulous data to profile the etiology and pathophysiology of this rare progressive disease, especially in low- and middle-income country. In Indonesia, the true prevalence and incidence of different subtypes of PAH in general population is still unknown. The Congenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry was the first single-center prospective registry in Indonesia, which indicated that almost 80% of adult patients with congenital heart disease (CHD) had experienced PAH and even Eisenmenger syndrome due to delayed diagnosis. Screening for early detection of asymptomatic CHD in children is yet to be systematically established in Indonesia, leading to undiagnosed and uncorrected CHD in adulthood. There are no specific national guidelines focusing on diagnostic workup and treatment of PAH in Indonesia. Furthermore, the lack of adequate diagnostic facilities, limited treatment availability, and limited drug coverage under the National Health Insurance Scheme are key issues that remain unaddressed. This review focuses on the diagnosis, treatment, and management of PAH associated with CHD in Indonesia as per international guidelines. We have proposed recommendations to effectively control and prevent PAH associated with CHD in Indonesia. The paper should be of interest to readers in the area of medical management and policy makers especially in low- and middle-income countries. Key Highlights: Pulmonary arterial hypertension (PAH) is a rare progressive subtype of pulmonary hypertension with poor overall prognosis and outcomes. Prompt and accurate diagnosis of PAH remains an unmet challenge in low- and middle-income countries due to poor knowledge about the etiology and pathophysiology of this syndrome. Also, the symptoms and signs of early-stage PAH are usually nonspecific or undetectable in newborn and infants, thus presenting a challenge for physicians to establish early diagnoses of PAH. The challenging factors in low- and middle-income countries, especially Indonesia archipelago are limitations of healthcare infrastructure, limited expertise, lack of awareness, lack of timely PAH screening strategies, poor antenatal care and unpredictable availability of PAH medications. There are no specific national guidelines focusing on diagnostic workup and treatment of PAH in Indonesia. Under-utilization of treatment guidelines and lack of adequate diagnostic treatment facilities have resulted in sub-optimal management of PAH patients in Indonesia. Adherence to international guidelines is an important aspect of PAH management in Indonesia. Updated disease and functional classifications of PAH as per internati...

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“…8 The other two articles in this issue are not less interesting, because they deal with widespread health problems in Indonesia, thalassemia and preeclampsia. 9,10 Since it is well known that thalassemia patients suffer from instability of their erythrocytes in blood circulation, it is very important to know, how far thalassemia trait of donors influences the stability of their stored blood. 9 Last but not least, we have a case of chronic thromboembolic pulmonary hypertension in a woman with history of Caesarian Section due to preeclampsia.…”

mentioning

confidence: 99%

“…9 Last but not least, we have a case of chronic thromboembolic pulmonary hypertension in a woman with history of Caesarian Section due to preeclampsia. 10 We hope that the collection of articles in this issue is a valuable finale of MJI. Volume 23, 2014 and we want to wish both our esteemed readers and our journal a successful and prosperous New Year, 2015.…”

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confidence: 99%