skip to main content

Chronic thromboembolic pulmonary hypertension — SCE Respiratory MCQ

Instant feedback + full explanation. One question, done properly.

HardPulmonary Vascular DiseaseChronic thromboembolic pulmonary hypertensionSCE Respiratory

A 56-year-old man remains breathless 9 months after a treated pulmonary embolism. Echocardiography shows RV dilatation and estimated PASP 62 mmHg. V/Q scan demonstrates multiple mismatched segmental perfusion defects, while CTPA shows webs and bands in both lower-lobe pulmonary arteries. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Lifelong anticoagulation and referral to a CTEPH centre

The persistent symptoms, mismatched V/Q defects and chronic thromboembolic changes indicate CTEPH, requiring lifelong anticoagulation and assessment at a specialist centre for operability and targeted therapy. Stopping anticoagulation is unsafe. PAH drugs may be used in selected cases but specialist CTEPH evaluation is central.

Reference: ESC/ERS Pulmonary Hypertension Guideline; NICE NG158