{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:00:03Z","timestamp":1787068803229,"version":"build-2736575974"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"VinUniversity's College of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe condition characterized by persistent dyspnoea and hypoxia. Diagnosis is challenging, especially when computed tomography pulmonary angiography (CTPA) shows no visible thrombi and symptoms overlap with common conditions like heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We present a 77-year-old female with heart failure with preserved ejection fraction who experienced progressive, refractory dyspnoea and hypoxia. Despite a CTPA showing no large, organized thrombi, a strong clinical suspicion prompted a ventilation\/perfusion (V\/Q) scan. The scan revealed multiple mismatched perfusion defects, confirming CTEPH. A workup for an incidental right ventricular thrombus did not reveal an underlying prothrombotic state.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case highlights the diagnostic difficulties of CTEPH when confounded by comorbidities. Persistent, unexplained hypoxia should trigger a comprehensive evaluation that includes a V\/Q scan, which remains the gold standard screening tool due to its high sensitivity. The management approach for inoperable patients requires careful consideration of approved medical therapies and patient-specific factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag034","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T12:40:09Z","timestamp":1769258409000},"source":"Crossref","is-referenced-by-count":1,"title":["A diagnostic challenge: unveiling chronic thromboembolic pulmonary hypertension in the absence of visible thrombi: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3675-711X","authenticated-orcid":false,"given":"Hoang","family":"Phu Quy","sequence":"first","affiliation":[{"name":"College of Health Sciences, VinUniversity , Vinhomes Ocean Park, Gia Lam District, 100000 Hanoi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3986-078X","authenticated-orcid":false,"given":"Dung","family":"Doan Duc","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Vinmec Times City , 458 Minh Khai Street, Vinh Tuy Ward, Hai Ba Trung District, 100000 Hanoi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8807-7653","authenticated-orcid":false,"given":"Thang","family":"Nguyen Duc","sequence":"additional","affiliation":[{"name":"College of Health Sciences, VinUniversity , Vinhomes Ocean Park, Gia Lam District, 100000 Hanoi, Viet Nam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"2026021309462036800_ytag034-B1","doi-asserted-by":"crossref","first-page":"3979","DOI":"10.3390\/ijms24043979","article-title":"Pathophysiology and treatment of chronic thromboembolic pulmonary hypertension","volume":"24","author":"Otani","year":"2023","journal-title":"Int J Mol 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