CTEPH Diagnosis

CTEPH can be a difficult disease to diagnose. To properly diagnose whether a patient has CTEPH, experts will run a number of tests. An accurate diagnosis of CTEPH is extremely important, as it will help the PH team decide which treatment will be best.

Common tests include:

  1. Ventilation/Perfusion Scan (V/Q Scan). The gold standard screening test for CTEPH, a V/Q Scan reveals any areas in the lung that not receive blood as expected when you breathe. This could indicate a blockage of the arteries by clots.
  2. CT scan.  This test is to look for blood clots and to evaluate other sections of the lungs that a V/Q Scan cannot detect. A patient receiving a CT scan may be given an IV that delivers a dye before the scan.
  3. Echocardiogram. In this procedure, a sticky gel is placed on the patient’s chest, near the heart. A technician or doctor will glide a wand that’s connected to a computer over the gel, and a sonogram of the heart is taken. This painless procedure is often used to make a preliminary diagnosis by estimating the pressures in the right heart and assessing how well the heart is squeezing and relaxing.
  4. Right-heart catheterization. Right-heart catheterization is the most accurate and useful test to get a definitive diagnosis of pulmonary hypertension. This test directly measures the pressure inside the heart and pulmonary arteries, and it should be done in all patients at least once to confirm a patient’s diagnosis with PH. During the test, doctors insert a small tube (called a catheter) into a large vein usually starting in the patient’s groin or neck. The doctors will then guide the catheter through the right side of the heart and into the pulmonary arteries, taking a number of pressure readings along the way.
  5. Pulmonary angiogram. Like a right-heart catheterization, a catheter is guided through a vein, usually starting in the neck or groin, into the pulmonary arteries. The pulmonary angiogram is then conducted by injecting dye into the arteries and taking pictures. This test will confirm the location of the chronic clots and help experts better understand how these clots are contributing to the patient’s pulmonary hypertension.
  6. Coronary angiogram. For patients who are deemed candidates for PTE and at risk of having coronary artery diesease, this test will evaluate  for any coronary artery disease. If the doctors identify significant coronary artery disease, they will typically treat it during the PTE procedure.

Once a diagnosis is made, doctors will recommend a treatment process. Go here to see CTEPH treatments.