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Chronic thromboembolic pulmonary hypertension — RCPSC IM MCQ

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HardCardiologyChronic thromboembolic pulmonary hypertensionRCPSC IM

A 63-year-old woman remains breathless 7 months after a treated pulmonary embolism. Echocardiography shows right ventricular enlargement and estimated pulmonary artery systolic pressure of 62 mmHg. CT pulmonary angiography during the acute event showed segmental clot, and current creatinine is normal. Spirometry is near normal. What is the most appropriate investigation?

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Correct answer: C — Ventilation-perfusion scan

Persistent pulmonary hypertension after pulmonary embolism raises chronic thromboembolic pulmonary hypertension. V/Q scanning is the preferred screening test because it is sensitive for chronic thromboembolic disease.

Reference: Canadian Thoracic Society pulmonary vascular disease resources