Case 15: CTEPH? But the Lung Scan Is Normal!

  • Victor J. TestEmail author
  • Deepa Gopalan
  • William R. Auger
Part of the Clinical Cases in Cardiology book series (CCC)


That CT angiography demonstrates evidence for chronic thrombus while the perfusion pattern on lung scintigraphy is normal can be readily explained. This case will demonstrate this “discrepancy” and underscores the value of a normal VQ scan in ruling out operable chronic thromboembolic disease.


Lung ventilation-perfusion scintigraphy Chronic thromboembolic disease 

Further Reading

  1. Archer S, Rich S. Primary pulmonary hypertension: a vascular biology and translational research “work in progress”. Circulation. 2000;02:2781–91.CrossRefGoogle Scholar
  2. Chaouat A, Weitzenblum E, Higenbottam T. The role of thrombosis in severe pulmonary hypertension. Eur Respir J. 1996;9:356–63.CrossRefGoogle Scholar
  3. Gopalan D, Blanchard D, Auger WR. Evaluation of chronic thromboembolic pulmonary hypertension. Ann Thorac Soc. 2016;13(Suppl 3):S222–39.CrossRefGoogle Scholar
  4. Moser KM, Fedullo PF, Finkbeiner WE, Golden I. Do patients with pulmonary hypertension develop extensive central thrombus? Circulation. 1995;91(3):741–5.CrossRefGoogle Scholar
  5. Perloff JK, Hart EM, Greaves SM, Miner PD, Child JS. Proximal pulmonary arterial and intrapulmonary radiologic features of Eisenmenger syndrome and primary pulmonary hypertension. Am J Cardiol. 2003;92:182–7.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Victor J. Test
    • 1
    Email author
  • Deepa Gopalan
    • 2
  • William R. Auger
    • 3
  1. 1.Division of Pulmonary Medicine and Critical CareTexas Tech University School of MedicineLubbockUSA
  2. 2.Department of RadiologyImperial College HospitalsLondonUK
  3. 3.Lewis Katz School of MedicineTemple UniversityPhiladelphiaUSA

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