V/Q scanning is a crucial diagnostic tool for uncovering CTEPH in patients with unexplained hypoxia, even in the absence of visible thrombi.
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.
Hoang et al. (2026) studied this question.