Abstract
That CT angiography demonstrates evidence for chronic thrombus while the perfusion pattern on lung scintigraphy is normal can be readily explained. This case will demonstrate this “discrepancy” and underscores the value of a normal VQ scan in ruling out operable chronic thromboembolic disease.
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Further Reading
Archer S, Rich S. Primary pulmonary hypertension: a vascular biology and translational research “work in progress”. Circulation. 2000;02:2781–91.
Chaouat A, Weitzenblum E, Higenbottam T. The role of thrombosis in severe pulmonary hypertension. Eur Respir J. 1996;9:356–63.
Gopalan D, Blanchard D, Auger WR. Evaluation of chronic thromboembolic pulmonary hypertension. Ann Thorac Soc. 2016;13(Suppl 3):S222–39.
Moser KM, Fedullo PF, Finkbeiner WE, Golden I. Do patients with pulmonary hypertension develop extensive central thrombus? Circulation. 1995;91(3):741–5.
Perloff JK, Hart EM, Greaves SM, Miner PD, Child JS. Proximal pulmonary arterial and intrapulmonary radiologic features of Eisenmenger syndrome and primary pulmonary hypertension. Am J Cardiol. 2003;92:182–7.
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Test, V.J., Gopalan, D., Auger, W.R. (2020). Case 15: CTEPH? But the Lung Scan Is Normal!. In: Auger, W., Gopalan, D. (eds) Clinical Cases in Chronic Thromboembolic Pulmonary Hypertension. Clinical Cases in Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-17366-1_15
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