Understanding CTEPH: Diagnosis, Treatment, and Comprehensive Care at AHN Allegheny General Hospital

Symptoms like shortness of breath, trouble doing physical activities, or leg swelling can impact your daily life. They could also be signs of a condition called chronic thromboembolic pulmonary hypertension (CTEPH).

While the condition may sound scary, CTEPH can often be treated. Doctors at AHN Allegheny General Hospital are here to help you determine the best treatment plan for your overall well-being and provide support every step of the way.

What is CTEPH?

CTEPH stands for chronic thromboembolic pulmonary hypertension. It is a form of pulmonary hypertension, or high blood pressure in the lungs.

CTEPH is often caused by blood clots in the lungs that never dissolved. The old blood clots can harden and block arteries in and around the lungs (pulmonary arteries). This makes your heart have to work harder to pump blood.

Common symptoms of CTEPH include:

• Shortness of breath
• Feeling extremely tired, especially during physical activity
• Chest pain
• Feeling lightheaded
• Swelling in the legs

If left untreated, CTEPH can lead to heart failure — but this is avoidable. If you or a loved one are experiencing these symptoms often, it’s important to talk to your doctor and get care.

“CTEPH is the only treatable form of pulmonary hypertension.” said Candice Lee, MD, cardiac surgeon at AHN. “I encourage you to speak up for yourself or others if something doesn’t seem right. People often brush symptoms off, but getting care can be life-changing, and even life-saving.”

NOTE: If you ever have severe heart symptoms — like sudden shortness of breath or chest pain — go to the nearest emergency room.

CTEPH risk factors

You may be at higher risk for developing CTEPH if you: 

• Previously had blood clots in your legs or lungs
• Recently had surgery that limited your ability to move around
• Have certain types of cancer
• Have recently been still for a very long time, like on a long car or plane ride
• Are using birth control pills
• Have had COVID-19

CTEPH can happen in young patients as well as older patients, so it’s important to know the symptoms and if any of these risk factors apply to you.

Diagnosing CTEPH at AGH

Symptoms of CTEPH can be similar to other conditions, like asthma. Getting a correct diagnosis is very important to make sure you get the right treatment.

Doctors at AGH will start by talking with you about your symptoms, lifestyle habits, medical history, and other risk factors.

After learning more about your health, doctors may do tests to check your heart and lungs, such as:

• Ventilation-perfusion (V/Q) scan – Uses imaging to find blood clots.
• Echocardiogram – Uses ultrasound to check how well your heart works.
• Right heart catheterization – Uses a thin tube placed through a vein in your neck, arm, or groin to measure pressure in your heart and lungs.
• Pulmonary angiogram – Uses imaging to show where blood clots are in the lung arteries.

Finding the right CTEPH treatment at AGH

Medications like blood thinners can help manage some CTEPH symptoms. However, the only way to completely unblock your arteries is with surgery.

AGH offers multiple procedures to treat CTEPH. Your care team will help you understand your options and decide which treatment is best for you.

Pulmonary thromboendarterectomy (PTE)

During PTE, doctors open the arteries in your lungs to remove the old blood clots blocking them.

PTE is the most effective treatment for CTEPH, but it may not be right for everyone. Sometimes, the blood clots may be in an area that doctors cannot safely reach. Your doctors will talk with you about your health and whether PTE is right for you.

Ballon pulmonary angioplasty (BPA)

BPA is a minimally invasive procedure, meaning doctors make fewer cuts in order to operate, which can lead to less pain and faster healing.

During BPA, doctors use a catheter to insert a small ballon in your pulmonary arteries. This helps open them and break up the blood clots blocking them.

You may need to have more than one BPA procedure on separate days to treat all the blood clots.

Ongoing CTEPH care

Recovery is different for each patient and type of procedure, but many people begin experiencing significant relief of CTEPH symptoms around 3 – 6 months after treatment.

Your care team will talk with you about any medications you should be taking and about the importance of follow-up care.

“CTEPH patients may be at higher risk for developing another blood clot,” said Dr. Lee. “Close monitoring and follow-up care is very important, and our team at AGH is with you every step of the way.”

Get life-saving CTEPH care

If you’ve previously had blood clots or are experiencing CTEPH symptoms, don’t wait to get care. Doctors at AHN Allegheny General Hospital are here to help you explore life-changing treatment options.

Learn more or call our direct CTEPH line to make an appointment: 412-442-2450.