Thromboembolic complications of COVID-19 leading to Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

Abstract

A middle-aged woman was diagnosed with Covid 19. Two months later she was referred to respiratory outpatients in view of worsening shortness of breath and decreased functionality. Investigations including a Computed Tomography pulmonary angiogram (CTPA) lead to the diagnosis of an acute right- sided pulmonary embolism, COVID-19, and bacterial pneumonia. Physical examination and echocardiogram revealed associated right heart strain. Further investigations at follow up confirmed the diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH).

The early diagnosis of the underlying CTEPH has allowed the patient to undergo bilateral pulmonary endarterectomy without undue delay. This was followed by intensive physical and respiratory rehabilitation. In turn the patient improved significantly, so much so that on follow up she was asymptomatic, and she was eventually able to regain her previous functional status.