Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Program
The Brigham and Women’s Hospital (BWH) Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Program offers advanced, focused, and comprehensive evaluation and treatment approaches for a subset of patients with pulmonary hypertension who experience recurring emboli (blood clots) in their lungs. Without effective treatment, this chronic disease can lead to life-threatening heart failure.
BWH is one of only a handful of hospitals nationwide that offer a comprehensive collaboration of medical, interventional, and surgical care for CTEPH. By bringing together experts from cardiothoracic surgery, pulmonary medicine, interventional cardiology, and cardiovascular medicine, we are better able to deliver the most appropriate and effective care for our patients with CTEPH.
What Is CTEPH?
An embolus is a mass of platelets and proteins that gets lodged in a blood vessel and blocks blood flow. In most cases, these blockages are either broken down successfully with medication or the clot dissipates on its own. In some cases, however, medication is ineffective and/or the clots recur with increasing frequency.
When these clots go unresolved, a process of inflammation and scarring turns these clots into blockages that are even harder to eliminate with conventional treatments. This leads to a form of pulmonary hypertension (high blood pressure in the blood vessels of the lungs) that is chronic and extremely dangerous.
Evaluation and Diagnosis
The primary symptom of CTEPH is an unexplained shortness of breath (dyspnea), which can be attributed to a wide variety of conditions. As a result, CTEPH is often misdiagnosed as one of these other conditions or is left undiagnosed.
As the disease progresses, other symptoms may appear, including:
water retention in the limbs (edema)
swelling or bloating of the abdomen
We use advanced diagnostic testing to determine whether patients have unresolved clotting in their lungs (CTEPH) or common pulmonary hypertension. We typically perform a right heart catheterization (to measure blood flow) and computed tomographic (CT) imaging of the pulmonary blood vessels and pulmonary arteries. This advanced testing also gives us a clearer picture of the nature of the disease, such as where it’s located in the lungs, helping us determine the best way to treat the disease.
Based on diagnostic testing and a multidisciplinary evaluation, our team will develop an individualized care plan that is tailored to the specific characteristics of a patient’s disease.
From evaluation to treatment to follow-up care, teamwork characterizes our program. Our medical, interventional, and surgical specialists work together at every step of care and ensure that patients and their families are informed and involved.