Akao Mitsumasa, Kubota Kayoko, Miyanaga Sunao, Mitsuyoshi Kokoro, Ohishi Mitsuru
Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
J Cardiol Cases. 2025 Jan 31;31(4):121-124. doi: 10.1016/j.jccase.2025.01.001. eCollection 2025 Apr.
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease characterized by pulmonary hypertension (PH), resulting from stenosis or occlusion of the pulmonary arteries owing to an organic thrombus that obstructs blood flow in the pulmonary arteries. The prognosis for untreated patients is poor; however, it has improved significantly with the advent of treatments such as PH-targeted medical therapy and pulmonary balloon angioplasty, in addition to pulmonary endarterectomy. Nevertheless, the exact mechanisms underlying this disease remain unknown. Recently, a close association between coronavirus disease 2019 (COVID-19) and thrombosis has been detected, with the risk of venous thrombosis complications increasing after COVID-19 infection; however, few studies have reported on the association between COVID-19 and CTEPH. Herein, we present the case of a young man who developed CTEPH after a mild COVID-19 infection, despite the lack of an obvious thrombophilic predisposition. We conclude that if a patient develops chronic shortness of breath symptoms after a COVID-19 infection, it is important to investigate not only the COVID-19 sequelae, but also the presence of other diseases such as pulmonary artery thrombosis.
Coronavirus disease 2019 (COVID-19) infection frequently causes abnormal blood coagulation and is closely related to thrombosis. Although pulmonary embolism is a frequent complication of venous thrombosis, few studies have reported an association between COVID-19 and chronic thromboembolic pulmonary hypertension (CTEPH). Our patient developed CTEPH after COVID-19 infection. It is important to examine organic abnormalities, before diagnosing persistent dyspnea as a COVID-19 sequela.
慢性血栓栓塞性肺动脉高压(CTEPH)是一种罕见疾病,其特征为肺动脉高压(PH),由有机血栓导致肺动脉狭窄或闭塞,阻碍肺动脉血流所致。未经治疗的患者预后较差;然而,随着肺动脉内膜剥脱术以及PH靶向药物治疗和肺动脉球囊血管成形术等治疗方法的出现,预后有了显著改善。尽管如此,该疾病的确切机制仍不清楚。最近,已发现2019冠状病毒病(COVID-19)与血栓形成密切相关,COVID-19感染后静脉血栓形成并发症的风险增加;然而,很少有研究报道COVID-19与CTEPH之间的关联。在此,我们报告一例年轻男性病例,该患者在轻度COVID-19感染后发生CTEPH,尽管缺乏明显的血栓形成倾向。我们得出结论,如果患者在COVID-19感染后出现慢性呼吸急促症状,不仅要调查COVID-19后遗症,还要调查是否存在其他疾病,如肺动脉血栓形成。
2019冠状病毒病(COVID-19)感染常导致异常凝血,与血栓形成密切相关。尽管肺栓塞是静脉血栓形成的常见并发症,但很少有研究报道COVID-19与慢性血栓栓塞性肺动脉高压(CTEPH)之间的关联。我们的患者在COVID-19感染后发生了CTEPH。在将持续性呼吸困难诊断为COVID-19后遗症之前,检查器质性异常很重要。