Nursing Student Class Projects (Formerly MSN)

Academic Term

Summer 2020

Document Type


Course Number

NURS 6810

Course Name

Advanced Pathophysiology for the Advanced Practice Nurse

Professor’s Name

Dr. Chovan & Dr. Butz


CTEPH, pulmonary hypertension, pulmonary thromboendarterectomy, pulmonary heart disease, pulmonary embolism

Subject Categories

Critical Care Nursing | Medicine and Health Sciences | Nursing | Respiratory Tract Diseases


Chronic pulmonary hypertension (CTEPH) is a rare and underdiagnosed complication of unresolved acute pulmonary embolism (PE). A chronic fibrotic thrombus replaces the unresolved emboli in the pulmonary vascular bed causing pre-capillary pulmonary hypertension (Mahmud et al., 2018). Symptoms rang from mild nonspecific such as exercise intolerance and dyspnea. As the disease progresses, symptoms present similarly to right ventricular heart failure (Gopalan et al., 2016). Although the pathophysiology and etiology of CTEPH is still not fully understood, risk factors include increased size of the PE, right ventricular strain, chronic inflammation, and defects in fibrinolysis among others (Fernandes et al., 2016). Treatment include pulmonary thromboendarterectomy, balloon pulmonary angioplasty, and medical management. Management of CTEPH patients presents many clinical complications for anesthesia providers as it impairs both respiratory and cardiac systems, so it is imperative that anesthesia providers “are well equipped to manage patients for surgeries with their potential complications” (Chen et al., 2019, p. 169).



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