Basic and Clinical Sciences (BCSE) Practice Exam

Chronic thromboembolic pulmonary hypertension (CTEPH) is a specific type of pulmonary hypertension that results from organized blood clots in the pulmonary arteries, leading to increased pressure and strain on the right side of the heart. Pulmonary endarterectomy is a surgical procedure that is indicated for the treatment of CTEPH, especially in patients who have persistent pulmonary hypertension despite anticoagulation therapy.

This procedure involves the surgical removal of the fibrotic tissue and organized thrombus from the pulmonary arteries. By restoring normal blood flow and reducing the pressure in the pulmonary circulation, pulmonary endarterectomy can significantly improve symptoms and overall prognosis in patients with CTEPH. This intervention is unique compared to the other options, which may play supportive roles in symptom management but do not directly address the underlying obstruction caused by chronic thromboembolic disease.

Oxygen therapy can be helpful in managing hypoxemia, but it does not treat the underlying cause of CTEPH. Diuretics can be used to manage fluid overload that sometimes occurs due to right heart failure, but they do not address the increased pulmonary vascular resistance. Vasodilators can be considered in various types of pulmonary hypertension, but their use in CTEPH is limited, especially in cases where