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A Rare Case of Chronic Thromboembolic Pulmonary Hypertension in an Elderly With Atrial Septal Defect and Eisenmenger Syndrome

Year: 2025

Type: article

Abstract: Atrial septal defects (ASDs) are among the most common congenital heart anomalies and often remain undetected until adulthood. While small ASDs may close spontaneously, larger unrepaired defects can lead to serious complications such as right heart failure, pulmonary arterial hypertension, Eisenmenger syndrome (ES), and thromboembolic events. We present a case of a 66-year-old Filipino female with a longstanding unrepaired secundum-type ASD, who was admitted with progressive dyspnea and hypoxemia. The patient developed atrial flutter, and further workup revealed severe pulmonary hypertension, right ventricular failure, and pulmonary embolism. Imaging confirmed chronic thromboembolic pulmonary hypertension (CTEPH), a rare but life-threatening complication in patients with ES. Despite aggressive medical management, including anticoagulation, antibiotics for pneumonia, and antiarrhythmic therapy, the patient's condition deteriorated, and she eventually succumbed to her illness. This case highlights the critical importance of early detection and surgical repair of large ASDs to prevent irreversible pulmonary vascular disease and associated complications such as ES and CTEPH, particularly in resource-limited settings where definitive interventions are often inaccessible.

Source: Cureus

DOI: 10.7759/cureus.90281

Authors: Ernestine Faye S Tan, Sakar B Gharti, Danielle Grace S Tan

Institutions: Interfaith Medical Center, University of Santo Tomas

Language: English

Topic: Cardiovascular and Diving-Related Complications

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4413441411