A Case of Chronic Thromboembolic Pulmonary Hypertension and Pregnancy, Managed With Pulmonary Endarterectomy: Clinical Challenges, Case Report, and Literature Review.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, potentially curable form of pulmonary hypertension, with limited data in pregnancy. We describe a 37-year-old woman with progressive dyspnea, back pain, and cough, whose evaluation revealed severe right ventricular enlargement, high pulmonary pressures, and extensive V/Q mismatches, confirming CTEPH. She underwent successful pulmonary thromboendarterectomy with marked hemodynamic recovery. An unrecognized early pregnancy, later confirmed after spontaneous miscarriage at 14 weeks, complicated the course. This case underscores the diagnostic challenges of CTEPH in women of reproductive age and highlights the impact of pregnancy-related hemodynamic stress on disease presentation.