Should right ventricle dilatation during exercise have clinical implications in patients with chronic thromboembolic pulmonary hypertension? Case report

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We describe the case of a 30-year-old female patient with chronic thromboembolic pulmonary hypertension that has an excellent functional capacity under treatment with sildenafil. She did an exercise stress echocardiography that revealed marked right ventricular dilatation during exercise. This information was used for clinical decision and the authors discuss the potential utility of this echocardiographyc sign.


In a patient suspected of acute coronary syndrome that after exercise echocardiography revealed right ventricular dilatation and conducted to the correct diagnosis of acute pulmonary thromboembolism.Another patient with chronic thromboembolic pulmonary disease and severe pulmonary arterial hypertension with good response to treatment with bosentan experienced the same phenomenon2. We now describe a third case that, in our opinion highlights the utility of exercise echocardiography in this clinical setting.

Case presentation
We report the case of a 30-year-old female patient, with a previous history of chronic pulmonary thromboembolism(PTE) and pulmonary arterial hypertension. She had C and S Protein deficit diagnosed at the first episode of PTE two years ago. She was referred to our Unit for studyand treatment.


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