Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare condition that affects blood flow through the lungs. Because it shares features with so many other heart and lung conditions, many people endure a long and frustrating journey before receiving an accurate diagnosis.

At Atrium Health Sanger Heart & Vascular Institute, we understand how overwhelming that can be. That’s why we’ve partnered with Atrium Health Wake Forest Baptist to build an expert, multidisciplinary team that specializes in diagnosing and treating this condition. We work alongside you to identify CTEPH early and create a personalized treatment plan that best fits your needs.

From CTEPH testing to surgery and recovery, we’re here to help improve your symptoms, restore blood flow through your lungs and support your long-term health.

CTEPH Symptoms

CTEPH symptoms often develop gradually and may worsen over time. Common signs and symptoms include:

• Shortness of breath, especially during physical activity
• Fatigue
• Chest pain or chest tightness
• Dizziness or lightheadedness
• Rapid or irregular heartbeat
• Swelling in the legs or ankles (edema)

Because these symptoms can mimic other cardiovascular or pulmonary conditions, evaluation by an experienced team is important for an accurate diagnosis.

CTEPH Treatments

Treatment for CTEPH depends on the location of the blockages, symptom severity and your overall health. Our team reviews each case collaboratively to determine the most appropriate approach.

Pulmonary Thromboendarterectomy (PTE) Surgery

Pulmonary thromboendarterectomy (PTE) is considered the gold-standard treatment for many people with CTEPH because it addresses the underlying cause of the disease: chronic blood clots and scar tissue blocking the pulmonary arteries.

Offered through our collaborative program with Atrium Health Wake Forest Baptist, this highly specialized surgery removes those obstructions and restores blood flow through the lungs. It's typically recommended when blockages are in larger, surgically accessible pulmonary arteries. Following surgery, many people experience significant improvement in symptoms and pulmonary artery pressure.

Because this surgery depends on the location of the blood clots and your overall health, our team carefully evaluates whether this surgery is the safest and most effective treatment for you.

Balloon Pulmonary Angioplasty (BPA)

When surgery is not possible or when the blood clots are located in smaller branches of the pulmonary arteries, a balloon pulmonary angioplasty (BPA) is often used instead.

During this minimally invasive procedure, a specialist guides a small balloon through a catheter and into the narrowed or blocked pulmonary arteries. The balloon is then inflated to open the blood vessel and improve circulation through the lungs.

Because this treatment is often performed in stages, most patients will require multiple BPA procedures over time.

Using Medication to Treat CTEPH

Although our team works hard to pursue every possible treatment option, not everyone with CTEPH will be eligible for surgery or a BPA. In some cases, blood clots are located in areas that are difficult to reach or other health conditions may make surgery too risky.

When that happens, medications, which often include long-term blood thinners, can help manage symptoms to improve blood flow and reduce strain on the heart.

Our Team Approach to CTEPH Treatment

Whether you receive care at our Winston‑Salem or Charlotte location, you’ll experience the same high‑quality standards, supported by close collaboration across our teams.

Our team includes:

• Pulmonary hypertension specialists
• Interventional cardiologists
• Cardiothoracic surgeons
• Imaging specialists
• Advanced heart failure cardiologists
• Interventional radiologists
• Pulmonologists
• Vascular medicine specialists
• Advanced practice providers

Tests for CTEPH

Diagnosing CTEPH typically requires a combination of imaging studies and specialized heart and lung testing. Your care team may recommend:

• Echocardiogram
• Ventilation-perfusion (V/Q) scan
• Pulmonary angiogram
• Right heart catheterization
• CT scan
• Six-minute walk test
• Cardiopulmonary exercise testing (CPET)

These tests help confirm a diagnosis, measure disease severity and guide treatment planning.

Can CTEPH Be Cured?

CTEPH may be curable for some people, especially when chronic blockages can be safely removed through PTE surgery. When surgery is successful, it can restore blood flow and significantly improve heart and lung function.

Even when a cure is not possible, effective treatments can help reduce symptoms, improve quality of life and support long-term health.

What Is the Life Expectancy With CTEPH?

While CTEPH is a serious and progressive disease, it is also one of the few forms of pulmonary hypertension that may be treated effectively with surgery or other targeted therapies. Life expectancy varies from person to person, but early diagnosis and treatment can make a significant difference.

Many people experience improved heart and lung function, increased exercise tolerance and better long-term outcomes after treatment.