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CTEPH signs and symptoms

CTEPH symptoms are nonspecific1:

  • Indistinguishable from symptoms of other forms of pulmonary hypertension (PH)

  • Can be mistaken for respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD)


On physical examination, initial findings consistent with CTEPH may include1:

  • A reduction in the splitting of the second heart sound (S2)

  • Accentuation of the sound of pulmonic closure (P2)

  • A palpable right ventricular heave


Subsequent findings correspond to decreasing right ventricular function1:

  • Jugular venous distention

  • Fixed splitting of S2

  • Right-sided third heart sound (S3)

  • Tricuspid regurgitation

  • Hepatomegaly, ascites, and peripheral edema


CTEPH symptoms graphic


1. Piazza G and Goldhaber SZ. Chronic thromboembolic pulmonary hypertension. N Engl J Med. 2011;364:351-360..