Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH), a complication of pulmonary embolism, is one of the major causes of right heart failure and death. It is characterised pathologically by organised thromboembolic material and altered vascular remodelling initiated and potentiated by a combination of defective angiogenesis, impaired fibrinolysis and endothelial dysfunction. One of the challenges in managing CTEPH is making early and accurate diagnoses and instituting prompt and appropriate treatment. We report four successfully managed cases of CTEPH occurring in two elderly males and two young females. All the patients were initially managed for cardiovascular disease and were referred to the respiratory unit after a period of four to eight months due to worsening dyspnoea. The diagnoses were made using a combination of CT angiogram, Doppler sonogram, and 2-D echo, and the patients were successfully managed medically. We aim to highlight the diagnostic and treatment challenges associated with CTEPH in Nigeria and the need for a high index of suspicion in dyspnoeic patients.

Key words: Fibrinolysis; Computed Tomography; Hypertension, Pulmonary Cardiovascular Diseases; Pulmonary Embolism