Trouble Breathing? How Doctors Can Uncover Hidden Disease in Your Lungs

Your medical history key to diagnosing CTEPH

Two doctors having a discussion about an x-ray of a human lung

If you have been short of breath or having a hard time breathing, tell your doctor if you have a history of deep vein thrombosis or pulmonary embolism. This can help uncover a condition that isn’t identifiable through routine tests.

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The condition is called chronic thromboembolic pulmonary hypertension (CTEPH) and it can be difficult to diagnose, says pulmonologist Gustavo Heresi, MD.

“CTEPH won’t show up on routine chest x-rays or breathing tests,” he says. “So if you don’t tell your doctor you have a history of pulmonary embolism or deep vein thrombosis, your doctor won’t know to look for CTEPH.”

When one or more blood clots get stuck in the arteries in your lungs, this can lead to increased pressure in your lungs and cause CTEPH. The good news is, in most instances, CTEPH is completely curable with early diagnosis and surgery.

How doctors identify and treat CTEPH

Even if you don’t have a history of pulmonary embolism or deep vein thrombosis, Dr. Heresi, says you still should be tested for CTEPH if you have unexplained shortness of breath or unexplained pulmonary embolism.

The most common screening test is a pulmonary ventilation/perfusion (V/Q) scan. A normal result on a V/Q scan will rule out the possibility of CTEPH.

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“If your doctor suspects you have CTEPH after your V/Q scan, additional tests will be done to confirm the diagnosis,” says Dr. Heresi.

Most likely, a surgery called a pulmonary thromboendarterectomy can cure your CTEPH. This surgery clears the clots from the arteries. Although this is a cure for the vast majority of people with CTEPH, some people are not good candidates.

“It’s important to visit a clinic that has specialty expertise in diagnosing and treating CTEPH before you determine whether or not you should have surgery,” Dr. Heresi says.

What happens if you’re not eligible for surgery?

If your medical team determines that you are not a good candidate for surgery, you can take medications as an alternate treatment method.

“There are new medications that can be effective for patients with CTEPH who are not eligible for surgery,” says Dr. Heresi.

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However, while medications are successful in managing the disease, they will not cure it.

Potential new treatment on the horizon

Researchers are in the process of testing whether or not a procedure called balloon pulmonary angioplasty is an effective treatment for patients with CTEPH who are not good candidates for surgery. However, it may be several years before the new treatment is approved and available.

“The research is still in its very early stages and requires additional study,” Dr. Heresi says.

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