Pulmonary Hypertension & Chronic Thromboembolic Disease Amritsar

Comprehensive guide to understanding pulmonary hypertension (PH) and chronic thromboembolic pulmonary hypertension (CTEPH) for patients and families in Amritsar and Punjab — causes, symptoms, diagnosis, treatment options including pulmonary endarterectomy and balloon pulmonary angioplasty, local resources, costs, and when to seek urgent care. Presented by Livasa Hospitals — Livasa Amritsar. For appointments call +91 80788 80788 or book online at Livasa Hospitals appointment.

Introduction to pulmonary hypertension and chronic thromboembolic disease

Pulmonary hypertension (PH) is a progressive condition in which the pressure in the pulmonary arteries — the blood vessels that carry blood from the right side of the heart to the lungs — becomes abnormally high. This increased pressure strains the right ventricle and, over time, may cause right heart failure. PH is not one single disease: it is a group of conditions that share elevated pulmonary arterial pressure as a defining feature. One specific, potentially curable cause of PH is chronic thromboembolic pulmonary hypertension (CTEPH), which develops when blood clots in the lungs fail to resolve and obstruct blood flow long-term, producing sustained pulmonary hypertension.

This guide is designed for patients and families in Amritsar and Punjab who want clear, practical, and reliable information about diagnosis, treatment, outcomes, and local options. We explain common symptoms such as shortness of breath, fatigue, and syncope; the tests used locally such as echocardiogram, V/Q scan, CT pulmonary angiography, and right heart catheterization; and available therapies ranging from anticoagulation and targeted medical drugs to interventional and surgical procedures like balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA).

Understanding PH and CTEPH empowers you to make timely decisions. Early diagnosis and management improves symptoms, exercise tolerance, and long-term outcomes. In Amritsar, Livasa Amritsar provides a coordinated pulmonary hypertension clinic that facilitates evaluation, advanced imaging, catheter-based interventions in a modern cath lab, multidisciplinary care and referral pathways for specialized surgery when required.

What is pulmonary hypertension and how is it classified?

Pulmonary hypertension is defined hemodynamically by an increased mean pulmonary artery pressure (mPAP). Clinically and for care pathways, PH is commonly grouped into five major categories based on cause and anatomy. Knowing the classification helps guide treatment:

• Group 1 — pulmonary arterial hypertension (PAH): includes idiopathic PAH, heritable PAH, and disease related to connective tissue disease or congenital heart disease. This group is treated with targeted pulmonary vasodilator drugs.
• Group 2 — PH due to left heart disease: the most common cause globally; management centers on treating left heart dysfunction.
• Group 3 — PH due to lung disease/hypoxia: seen with COPD, interstitial lung disease, or sleep apnea; oxygen and treating the lung disease are front-line.
• Group 4 — chronic thromboembolic pulmonary hypertension (CTEPH): caused by unresolved thromboembolic obstruction after acute pulmonary embolism; potentially curable by pulmonary endarterectomy for many patients or treatable with BPA and medical therapy.
• Group 5 — PH with unclear or multifactorial mechanisms: includes hematological or metabolic disorders with complex contributors.

For patients in Amritsar, recognizing which group applies is essential: CTEPH (group 4) has a different diagnostic pathway (V/Q scan first-line) and distinct curative surgical options (pulmonary endarterectomy) not used for other types of PH. A diagnosis is often established through a combination of echocardiography and confirmatory right heart catheterization. At Livasa Amritsar, we ensure systematic evaluation so that patients are accurately classified and routed to the most effective care.

Causes and risk factors, with emphasis on CTEPH

The causes of pulmonary hypertension are diverse. In many patients, PH develops secondary to heart or lung disease, but for a subset the problem arises from obstructed or diseased pulmonary vasculature. Understanding a patient’s risk profile is key to prevention, timely diagnosis and appropriate referral:

• Previous pulmonary embolism or venous thromboembolism: The single most important risk for CTEPH. After an acute pulmonary embolus, a small percentage of patients (generally reported around 1–3% in modern series) go on to develop chronic thromboembolic obstruction and PH if clots fail to resolve and organise within the pulmonary arteries.
• Pro-thrombotic states: including antiphospholipid syndrome, clotting factor abnormalities, cancer, and some chronic inflammatory diseases increase vulnerability to recurrent clots and CTEPH.
• Cardiac causes: left heart disease, valve disease, or heart failure are common contributors to PH (group 2).
• Lung disease and hypoxia: COPD, interstitial lung disease or obstructive sleep apnea can chronically elevate pulmonary pressures (group 3).
• Genetic predisposition and rare conditions: some forms of PAH are heritable and occur without lung or heart disease.
• Other risk modifiers: age (incidence higher with increasing age), chronic immobilization, and central venous catheters in some contexts.

In Punjab and around Amritsar, raising awareness of pulmonary embolism symptoms and prompt anticoagulation for acute events is an important public health goal to reduce the future burden of CTEPH. If you have had a prior pulmonary embolism and now experience progressive breathlessness or reduced exercise tolerance, evaluation for CTEPH should be considered.

Symptoms and when to seek care

Symptoms of pulmonary hypertension can be subtle initially and often mimic more common conditions such as asthma or deconditioning. Recognizing red flags is essential, especially in patients with known risk factors such as previous pulmonary embolism. Common symptom patterns include:

• Shortness of breath (dyspnea): initially on exertion, progressively occurring with routine daily activities.
• Excessive fatigue: even with light activity.
• Chest discomfort or a feeling of pressure: not necessarily typical angina.
• Palpitations or syncope (fainting): especially with exertion — a concerning sign indicating more advanced disease.
• Swelling in the ankles, legs, or abdomen: signs of right heart strain and fluid retention.
• Persistent cough or hemoptysis (coughing blood): may occur in some cases, including CTEPH.

When to seek urgent care in Amritsar or Punjab:

• Sudden severe shortness of breath, chest pain, or collapse: treat as a medical emergency and call local emergency services or present to the nearest emergency department (pulmonary embolism emergency treatment Amritsar).
• Worsening dizziness or syncope with activity: requires urgent cardiology review.
• Rapid swelling or sudden weight gain: may indicate worsening right heart failure that needs prompt outpatient or inpatient care.

If you live in Amritsar and have a history of blood clots, recent immobilization, or signs described above, contact a pulmonary hypertension specialist. Livasa Amritsar offers a pulmonary hypertension clinic where symptomatic patients can be quickly assessed and triaged for urgent diagnostic tests.

Diagnosis: tests, sequences and what to expect in Amritsar

Accurate diagnosis of PH and especially confirmation of CTEPH requires a stepwise approach. At Livasa Amritsar and similar centres in Punjab, the following diagnostic pathway is typically followed: clinical assessment, transthoracic echocardiogram, ventilation-perfusion (V/Q) scan (essential for CTEPH screening), CT pulmonary angiography (CTPA), and definitive hemodynamic measurement with right heart catheterization. Below we describe each test, its purpose and what patients can expect.

• Echocardiogram (echo): a non-invasive ultrasound of the heart used to estimate pulmonary pressures, assess right ventricular size and function, and identify left-sided heart disease. This is the usual first-line screening test.
• V/Q scan (ventilation-perfusion scan): the most sensitive initial test for CTEPH. A mismatched perfusion defect on V/Q scan should prompt specialist referral. In Amritsar, a V/Q scan is performed at select imaging centres and is central to CTEPH diagnosis (V/Q scan Amritsar — inquire about availability and V/Q scan cost Amritsar).
• CT pulmonary angiography (CTPA): high-resolution CT imaging to visualise thromboembolic obstruction, vessel chronicity, and lung parenchyma. Useful for surgical planning and to evaluate for alternative causes.
• Right heart catheterization (RHC): the gold standard for diagnosing pulmonary hypertension by directly measuring pulmonary artery pressures and cardiac output. RHC also measures pulmonary vascular resistance — a key value for treatment decisions (right heart catheterization Amritsar).
• Pulmonary angiography: invasive catheter angiography may be performed during BPA planning or at centres that perform advanced interventional procedures for CTEPH.

Comparison of key diagnostic tests

Patients in Amritsar should discuss with their clinician which tests are needed urgently. A V/Q scan remains the recommended screening test if CTEPH is suspected because it detects perfusion mismatches that CTPA may miss. Livasa Amritsar coordinates access to these imaging tests and will arrange right heart catheterization in our cath lab as part of the diagnostic pathway where indicated.

Treatment options: medical, interventional and surgical

Treatment of pulmonary hypertension depends on its cause and severity. For many patients with CTEPH, there are three principle approaches: lifelong anticoagulation, definitive surgery (pulmonary endarterectomy) when anatomically suitable, and balloon pulmonary angioplasty for peripheral disease or residual/recurrent disease after surgery. Medical therapies used in other PH groups (such as PAH) can also be employed in inoperable CTEPH or as bridging therapy.

Medical therapies and supportive care

• Anticoagulation: essential for CTEPH and for many patients after pulmonary embolism. Lifelong anticoagulation is commonly recommended for proven CTEPH to prevent further clots.
• Targeted pulmonary vasodilators: drugs such as endothelin receptor antagonists, phosphodiesterase-5 inhibitors, soluble guanylate cyclase stimulators and prostacyclin analogues are used in PAH and sometimes in inoperable CTEPH.
• Diuretics and oxygen: for fluid control and hypoxia management.
• Cardiac and respiratory rehabilitation: exercise training and education programs improve functional capacity and quality of life.

Interventional and surgical options

• Pulmonary endarterectomy (PEA): a major open surgical procedure that removes organized thromboembolic material from the pulmonary arteries and can be curative in appropriately selected patients with proximal disease.
• Balloon pulmonary angioplasty (BPA): a catheter-based procedure where balloons dilate narrowed pulmonary arteries, useful for distal disease or patients not suitable for PEA. BPA is increasingly offered in specialized centres including interventional programs associated with modern cath labs.
• Transplantation: lung or heart-lung transplant is considered for selected patients with advanced disease refractory to other treatments.

Comparison of PEA vs BPA vs medical therapy (CTEPH context)

In Amritsar, Livasa Amritsar evaluates each CTEPH patient in a multidisciplinary meeting involving cardiology, cardiothoracic surgery, radiology and pulmonary specialists to determine whether PEA, BPA, medical therapy or combined approaches are best. For patients needing pulmonary endarterectomy who require referral to specialized national centres, Livasa facilitates rapid referral and shared-care arrangements to ensure a smooth pathway.

Outcomes, prognosis and relevant statistics

Prognosis in pulmonary hypertension varies widely depending on the underlying cause and how early effective therapy is instituted. For pulmonary arterial hypertension (PAH), historical five-year survival rates were around 50–60%; with modern targeted therapies and earlier diagnosis, outcomes are improving, and contemporary registry data suggest better long-term survival. For CTEPH, outcome depends crucially on anatomy and timely referral: patients who undergo successful pulmonary endarterectomy have excellent hemodynamic and symptomatic improvement and substantially improved long-term survival compared with inoperable patients.

Key statistics (global and regional context):

• Global prevalence: The umbrella of pulmonary hypertension affects a range of patients; pulmonary arterial hypertension (PAH) is a rare disease with estimated prevalence between 15–50 cases per million in many published series.
• CTEPH incidence after pulmonary embolism: modern studies estimate that roughly 1–3% of patients develop CTEPH following an acute pulmonary embolus; the risk appears higher with recurrent or unprovoked clots and in pro-thrombotic states.
• Survival improvements: contemporary registries show improved outcomes with specialized care, early diagnosis and multimodality treatment. For operable CTEPH treated with PEA, many centres report normalization of pulmonary pressures or substantial reductions and good long-term survival.
• Local context (Punjab/Amritsar): exact community prevalence data for pulmonary hypertension and CTEPH in Punjab are limited, but referral volumes to tertiary centres in Punjab are rising, reflecting improved recognition and diagnostic capability locally. Early referral of suspected PH increases the chance of optimal therapy in Amritsar or referral to national expert centres when needed.

These numbers highlight two important points for patients in Amritsar: first, pulmonary hypertension is uncommon but serious and should be evaluated in specialist centres; second, when CTEPH is recognized early and treated at experienced centres, outcomes can be excellent. Livasa Amritsar works with regional registries and networks to ensure patients have access to evidence-based care and follow-up.

Living with pulmonary hypertension: follow-up and lifestyle

A diagnosis of PH or CTEPH is life changing, but many patients lead active lives with appropriate treatment, monitoring and lifestyle adjustments. Long-term follow-up at a specialist clinic is crucial for medication titration, monitoring of right heart function, and early detection of complications. Follow-up also creates opportunities for cardiac rehabilitation and education — both improve quality of life and physical capacity.

Key elements of living well with PH and CTEPH:

• Regular specialist follow-up: scheduled visits typically every 3–6 months or more often during changes in therapy. Tests include echo, blood tests (BNP/NT-proBNP), and functional assessment (6-minute walk test).
• Adherence to medications and anticoagulation: strict adherence reduces risk of recurrent thrombosis and controls symptoms.
• Exercise and rehabilitation: supervised programs tailored to individual tolerance improve endurance and reduce breathlessness.
• Pregnancy counselling: pregnancy carries significant risk in many forms of PH; early specialist discussion is needed for family planning.
• Travel and vaccinations: patients with PH should plan travel with oxygen availability if required, avoid long immobilization without prophylaxis, and keep vaccinations (influenza, pneumococcal, COVID-19) up to date.
• Mental health and support groups: living with a chronic disease can be emotionally challenging. Peer support groups and psychological counselling can be invaluable.

Livasa Amritsar provides structured follow-up care and rehabilitation programs. Patients are offered education on self-monitoring (daily weight, symptom diary), and guidance on safe physical activity, travel planning and pregnancy counselling where relevant. For families, understanding the disease helps provide a supportive home environment that improves adherence and outcome.

Why choose Livasa Amritsar for pulmonary hypertension and CTEPH?

Patients in Amritsar and surrounding areas seeking care for pulmonary hypertension and CTEPH benefit from a centralised, multidisciplinary approach. Livasa Hospitals — Livasa Amritsar offers several distinct strengths for PH care:

• Multidisciplinary pulmonary hypertension clinic: coordinated assessments by cardiologists, pulmonologists, radiologists and rehabilitation specialists.
• Advanced diagnostic capability: on-site echocardiography, coordination for V/Q scan and CT pulmonary angiography, and experience in performing right heart catheterization in a modern cath lab (right heart catheterization Amritsar).
• Interventional expertise: access to experienced interventional cardiologists able to perform balloon pulmonary angioplasty (balloon pulmonary angioplasty Amritsar) where indicated.
• Referral networks: where pulmonary endarterectomy is required and best performed at a high-volume cardiothoracic centre, Livasa Amritsar facilitates referral and shared care to ensure continuity and post-operative follow-up locally.
• Comprehensive follow-up and rehabilitation: structured cardiac and pulmonary rehab programs and close monitoring to optimise long-term outcomes.

To arrange an assessment at Livasa Amritsar, call +91 80788 80788 or book online. Our team can guide you through necessary tests (V/Q scan Amritsar, CT pulmonary angiography Amritsar), explain likely costs and arrange rapid referral when surgery is needed.

Costs, referrals and what to expect at your first visit

Cost estimates vary based on the tests and treatments required. Below are approximate ranges commonly seen in Amritsar and larger Indian referral centres. These are indicative and will vary based on exact protocols, hospital stay length and whether specialised surgical referral is required.

These estimates are indicative. For an accurate personalised cost plan, please contact Livasa Amritsar so our team can provide a detailed breakdown, help with insurance authorization and discuss financing where needed (pulmonary hypertension treatment cost Amritsar, chronic thromboembolic disease treatment cost Amritsar).

What to expect at the first visit:

• Comprehensive clinical history including prior pulmonary embolism or clotting problems
• Baseline tests: ECG, echocardiogram and blood tests; planning for V/Q scan or CTPA if CTEPH is suspected
• Discussion of possible next steps: right heart catheterization, anticoagulation initiation, or referral for PEA/BPA as indicated
• A clear follow-up plan and contact numbers for urgent concerns

Frequently asked questions and next steps

Below are answers to common patient questions for people in Amritsar and Punjab considering evaluation for pulmonary hypertension or CTEPH.

• Q: If I had a pulmonary embolism years ago, should I be screened for CTEPH?
  A: If you have persistent or progressive breathlessness since your clot, or new symptoms, screening with an echocardiogram and V/Q scan is reasonable. Discuss referral to a PH clinic for timely evaluation.
• Q: Is pulmonary endarterectomy available in Amritsar?
  A: PEA is a complex surgery typically performed at specialised high-volume thoracic centres. Livasa Amritsar evaluates candidates locally and coordinates referral and follow-up when surgery is indicated.
• Q: How many BPA sessions will I need?
  A: BPA is staged over several sessions; the number varies by disease extent and patient response. Your interventional team will advise a tailored plan.
• Q: Are there local pulmonary hypertension specialists?
  A: Yes — Livasa Amritsar provides pulmonary hypertension specialists and a multidisciplinary team. To schedule, call +91 80788 80788 or book via our website.

Next steps: If you or a loved one have symptoms or a history of pulmonary embolism, early discussion with a specialist improves outcomes. Contact Livasa Amritsar for an initial assessment and to arrange the appropriate diagnostic tests (diagnosis of pulmonary hypertension Amritsar, pulmonary embolism Amritsar, blood clot in lung Amritsar).

Disclaimer: This article provides general information for patients and is not a substitute for medical assessment. Costs and services vary; please contact Livasa Amritsar for personalised advice and the most up-to-date information on diagnostic availability and treatment pathways.