A Guide to Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

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Chronic Thromboembolic Pulmonary Hypertension (CTEPH): An Introduction

Chronic thromboembolic pulmonary hypertension (CTEPH)  is the high blood pressure in the arteries of the lungs that occurs probably due to blood clots and the formation of scar tissues. Blood clot in the lungs is known as pulmonary embolism which is the common cause of chronic thromboembolic pulmonary hypertension. Around 1 to 5 % of patients with pulmonary embolism are likely to get CTEPH.

On an estimation, around 5000 cases of chronic thromboembolic pulmonary hypertension are reported every year in the US and can encounter anyone. Riociguat is the only approved medicine used to treat CTEPH. This often interacts with pills like cenforce 100 and leads to some severe side effects. Cenforce 100 aids in providing firm and long-lasting erections.

Symptoms Of Chronic Thromboembolic Pulmonary Hypertension

The symptoms of chronic thromboembolic pulmonary hypertension are often slow and are mostly similar to that of the other diseases that makes diagnosis of chronic thromboembolic pulmonary hypertension difficult. Some of the common symptoms of chronic thromboembolic pulmonary hypertension are:

  • Extreme fatigue
  • Excessive weakness and tiredness
  • Shortness of breath, mostly while exercising
  • Pain or palpitations in the chest
  • Fluid retention can lead to edema or swelling in the legs
  • Fainting
  • Cyanosis or development of blue colour to finger and toes

Apart from these common symptoms, in rare conditions chronic thromboembolic pulmonary hypertension can lead to coughing up blood.

Causes Of Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

The formation of scar tissues due to blood clots in the lungs is the main cause of chronic thromboembolic pulmonary hypertension. Sometimes the blood clots form in your lungs due to improper blood flow which gets targeted into scar tissue. These scar tissues to the narrowing of the blood vessels and sometimes even block them. This, in turn, exerts pressure on the heart to pump blood through the body causing the blood pressure to rise.

Following are the causes that can lead to the formation of blood clots in your lungs:

  • Increased age
  • Obesity
  • Consumption of birth control pills with estrogen as an ingredient
  • Certain forms of cancer
  • Smoking
  • Prolonged sitting or lying in a fixed position
  • Surgery

However, the risk factors that can increase your chances of getting chronic thromboembolic pulmonary hypertension are:

  • Untreated pulmonary embolism
  • Absence of spleen
  • Undergoing thyroid replacement therapy
  • A few blood clotting disorders like such as lupus anticoagulant or antiphospholipid syndrome
  • Having a pacemaker that gets infected
  • Having blood that is not an O type.

Diagnosis Of Chronic Thromboembolic Pulmonary Hypertension

Although chronic thromboembolic pulmonary hypertension is hard to diagnose, the following tests can help your doctor to suspect the disease:

Lung V/Q Scan Or Ventilation/perfusion scan

This is the first test doctors use to detect CTEPH. In this test, the doctor will deliver a radioactive protein into your bloodstream via injection which is then used to detect the flow of blood through your lungs with the help of an X-ray.

CT Scan Or Computed Tomography

To detect the presence of blood clots CT scan is done where a dye is injected into your vein and examined with the help of an X-ray.

Right-Heart Catheterization

In this procedure, the doctor will insert a catheter into the blood vessel of your groin, wrist or neck area from where it is guided to the right side of your heart and then to the lungs to measure the blood pressure.

Electrocardiogram

With the help of sound waves, the doctor takes a detailed picture of your heart to measure the pressure on its right side and how it is pumping blood.

Pulmonary Angiogram

This test is done to detect the presence of any blockage in the arteries of your lungs. The catheter is guided towards your lungs and with the help of a dye, pictures of your lungs are taken to see the blockage, if any.

Treatment Of Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

A pulmonary thromboendarterectomy (PTE), also called a pulmonary endarterectomy is an effective surgery used to treat CTEPH which gives relief to around 90% of patients suffering from chronic thromboembolic pulmonary hypertension. During this surgery, the doctor makes an incision in your breastbone. You are put on a heart-lung machine and cooled from 37 degrees Celsius to 18 degrees Celsius.

Once cooling is done, the circulation stops and your heart temporarily stops working which lets your doctor examine the arteries. Then the specialist surgeon uses specialized tools to remove the clots from your arteries.

In case you don’t want to go for an open surgery then you may opt for:

Percutaneous Balloon Pulmonary Angioplasty

This surgery uses a catheter and a balloon to remove the scar from the arteries. It is generally carried out more than once.

Double Lung Transplant

In this surgery, your infected lungs are replaced with healthy lungs from a donor.

However, if surgery isn’t useful for you then your doctor may suggest Riociguat medications. This is the only drug available yet to treat people suffering from CTEPH.

However, the medicine may interact with PDE5 inhibitors like cenforce 100 used to treat erection issues in men. Cenforce 100 helps in improving the blood flow to the penis by relaxing the penile muscles thereby leading to an erection.

When Riociguat interacts with cenforce 100 the effect of your medications increases. Hence the interaction between Riociguat and cenforce 100 can result in weakness, fatigue, dizziness, loss of consciousness. Hence it is advisable to consult a doctor if you are planning to combine Riociguat and cenforce 100.

Complications Of The Treatments Of Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

Surgery of chronic thromboembolic pulmonary hypertension is quite delicate and risky. After the surgery, you need to remain hospitalised for at least 10 days. It takes around 2 months for the wound to get healed. Also, taking Riociguat to treat CTEPH results in side effects like nausea, dizziness, swollen feet and legs and headache.

Summary

Chronic thromboembolic pulmonary hypertension can be severe if left undiagnosed. Untreated pulmonary embolism is one of the leading causes of chronic thromboembolic pulmonary hypertension. Surgery is a possible and effective way to get it treated. However, Riociguat is an approved and the only available pill used for treating chronic thromboembolic pulmonary hypertension.

 

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