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CTEPH Reassessment for PAH Patients

Following PTE, patients must be closely monitored and reassessed regularly.

  • Up to one-third of patients may have residual CTEPH following PTE.*25

CTEPH is often misdiagnosed due to nonspecific symptoms and variable disease course.2

  • V/Q scans, which are >96% sensitive for detecting CTEPH and which effectively rule out CTEPH when negative, are underutilized in screening PH patients.3,23
  • A US registry of patients (N=786) who had been diagnosed with PAH revealed that 43% had been diagnosed with PAH despite never having received a V/Q scan to screen for CTEPH.30
    • In approximately one-third of these cases without a V/Q scan, the healthcare provider, when asked why a V/Q scan was not performed, answered that it was not relevant.30

Consider reassessing PAH patients who have not received a V/Q scan to see if they have potentially operable, potentially curable CTEPH.

  • A V/Q scan is an important diagnostic test for patients with suspected PH or PE patients who are still symptomatic after 3 months of anticoagulation.6

If a V/Q scan suggests CTEPH3, the patient should be referred to a specialized center with expertise in the treatment of this condition.

  • Watch the following videos to learn more about common myths and realities about V/Q scans:

  • Myth: A V/Q scan is contraindicated in patients ​with PH

    Click to Play Video

  • Myth: A V/Q scan is enough to make a definitive diagnosis

    Click to Play Video

  • Myth: If signs point to PH, there is no need for a V/Q scan

    Click to Play Video

*Also called pulmonary endarterectomy or PEA.

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Consider reassessing PAH patients who have not received a V/Q scan.

Reassessing a Misdiagnosis

 

Ivan Robbins, MD, of Vanderbilt University Medical Center, Nashville, presents a case illustrating the importance of the ventilation/perfusion scan as a screen for CTEPH.

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