Thelansis

  Chronic thromboembolic disease (CTED) presents symptoms and perfusion defects similar to CTEPH but lacks PH at rest. A new threshold for PH diagnosis, defined as mean PAP (mPAP) >20 mmHg, along with criteria for pre-capillary PH (mPAP >20 mmHg, pulmonary arterial wedge pressure ≤15 mmHg, and pulmonary vascular resistance (PVR) ≥3 Wood Units), has been established. Lung ventilation/perfusion scintigraphy is the preferred screening test, with a normal scan effectively ruling out CTEPH. CTEPH falls under group 4 PH and is pathologically characterized by organized thromboembolic material and altered vascular remodeling, influenced by defective angiogenesis, impaired fibrinolysis, and endothelial dysfunction. These changes precipitate PH, leading to right ventricular failure. While the exact pathogenesis remains unclear, acute pulmonary embolism is believed to trigger CTEPH, with documented antecedent history in patients. Several abnormal autoimmune, inflammatory, and thrombop...