Chronic thromboembolic pulmonary hypertension (CTEPH) is a condition characterized
by persistent obstructive thrombi that lead to vascular scarring and subsequently,
progressively elevated pulmonary arterial pressure. These thromboemboli generally
originate from deep venous thrombosis (DVT), typically from the lower extremities.1 We present an unusual case of CTEPH due to a rare anterior mediastinal venous malformation
(VM) that was previously misdiagnosed in infancy as a cystic hygroma. Mediastinal
vascular malformations are uncommon, and embolization to the pulmonary arteries from
a VM is a rare event.2 Early diagnosis and a multidisciplinary approach can enable prompt follow-up and
treatment of this condition to mitigate adverse consequences of pulmonary hypertension.
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