Research Article
Volume 5 Issue 6 - 2021
The Incidence of Chronic Thromboembolic Pulmonary Hypertension based on Echocardiography Finding After Acute Pulmonary Embolism in Omani Population
Afra Hassan Al Balushi1* and Al Busaidi N2
1Internal Medicine Department, Royal Hospital, Muscat, Sultanate of Oman
2Respiratory Medicine Department, Royal Hospital, Muscat, Sultanate of Oman
*Corresponding Author: Afra Hassan Al Balushi, Internal Medicine Department, Royal Hospital, Muscat, Sultanate of Oman.
Received: April 24, 2021; Published: May 17, 2021




Abstract

Background: Chronic thromboembolic pulmonary hypertension (CTEPH) is a common and fatal sequel of acute pulmonary embolism (APE) however it is potentially curable without the need for lung transplantation. The estimated incidence of CTEPH is about 0.5 to 3.8% in a patient after an acute single episode of pulmonary embolism. It is important to detect CTEPH and to prevent its progression. We aimed to determine the incidence of CTEPH based on Echocardiography findings and identify its associated risk factors in Omani adult population after acute pulmonary embolism (APE).

Methods: Out of 372 patients who have confirmed APE, 57 patients were enrolled in the study as they met the inclusion criteria and have echocardiography done at least 3 months from the diagnosis of APE. Risk factors were classified according to CT extension of the APE and etiology of the PE in the studied population.

Results: 57 patients were included in this study with a mean age of 48 years and almost equal percentage of patients were observed in each gender. 39 patients (68.4%) had bilateral APE with 47 patients (82.5%) and 10 patients (17.5%) presented with proximal and distal APE, respectively. The number/percentage of patients with risk factors for thromboembolism, lupus anticoagulant, unclassified thrombophilia, factor V Leiden deficiency, idiopathic, and malignancy, were 14 (24.6%), 1 (1.8%), 3 (5.3%), 3 (5.3%), and 9 (15.8%), respectively, while the percentage/number of patients with unknown risk factors were 2 (3.5%), and provoked APE were 25 (43.9%). The pulmonary arterial systolic pressure was found to be high, > 35 mmHg, in 13 patients (22.8%). Right ventricular and right atrial dilatations were observed in 6 patients (10.5%). Four patients (7%) have CTEPH confirmed with right heart catheterization and are already in follow up with chest medicine department. The association between risk factors and outcomes was declined because of the small sample size.

Conclusion: The incidence of CTEPH based on echo is high as 22.8% based on high PASP and 10.5% based on right sided heart dilatation/dysfunction, while only four patients (7%) of them has confirmed CTEPH after right heart catheterization. A lot of them has lost follow up because there were no previous guidelines to follow up for CTEPH.

Keywords: Acute Pulmonary Embolism; CTEPH; Echocardiography; High Pulmonary Pressure

References

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Citation: Afra Hassan Al Balushi and Al Busaidi N. “The Incidence of Chronic Thromboembolic Pulmonary Hypertension based on Echocardiography Finding After Acute Pulmonary Embolism in Omani Population”. EC Emergency Medicine and Critical Care 5.6 (2021): 04-09.

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