Abstract

A 23-year-old cyclist discontinued competitive cycling because of severe breathlessness on exertion. A cycle ergometer exercise test revealed marked oxygen desaturation at moderate levels of exercise. A ventilation-perfusion lung scan demonstrated bilateral pulmonary emboli, and a pulmonary angiogram confirmed chronic thromboembolic pulmonary hypertension. The patients pulmonary hypertension reached peak levels during exercise, and he was instructed to refrain from maximal exertion. The patient declined medical therapy and resumed regular exercise. Due to worsening symptoms and right ventricular enlargement, he was referred for a pulmonary thromboendarterectomy. He tolerated the procedure well and a significant amount of scar tissue was removed from the pulmonary arteries. The postoperative ventilation-perfusion scan pulmonary angiogram demonstrated complete resolution of his perfusion defects. His right ventricular size returned to normal. The patient has resumed competitive cycling, without inappropriate breathlessness. Verf.-Referat