title: [Chronic thromboembolic pulmonary hypertension: diagnostic limitations].
abstract: Chronic thromboembolic pulmonary hypertension is the only potentially curable form of pulmonary hypertension, assuming that surgical treatment is possible. However, there are hindrances to making a definitive, noninvasive diagnosis. We present the case of a 40-year-old female patient with idiopathic pulmonary arterial hypertension, confirmed in 1994. This patient developed thrombi in pulmonary vessels (as an overlap syndrome) mimicking chronic thromboembolic pulmonary hypertension. The identification of these conditions, which present high intraoperative mortality and unsatisfactory surgical resolution, is quite difficult in clinical practice. We discuss the current approach to candidate selection for surgical treatment of chronic thromboembolic pulmonary hypertension and the possible repercussions of inappropriate selection.
authors.affiliation: Grupo de Circulação Pulmonar do Serviço de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Bruno Arantes
authors.initials: BA
authors.lastname: Dias
authors.forename: Carlos
authors.initials: C
authors.lastname: Jardim
authors.forename: André
authors.initials: A
authors.lastname: Hovnanian
authors.forename: Caio Júlio César
authors.initials: CJ
authors.lastname: Fernandes
authors.forename: Rogério
authors.initials: R
authors.lastname: Souza
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004691:Endarterectomy; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D018579:Patient Selection; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D011859:Radiography; D014655:Vascular Resistance