Post-tuberculosis pulmonary hypertension and related vascular sequelae
Keywords:
cardiovascular diseases; fibrosing mediastinitis; hypertension; pulmonary vascular diseases; tuberculosisAbstract
Introduction: Tuberculosis (TB) remains a leading global infectious killer, and survivors frequently develop long-term vascular complications. Post-tuberculosis pulmonary hypertension, fibrosing mediastinitis, and systemic cardiovascular and cerebrovascular sequelae are increasingly recognized but remain underdiagnosed.
Objective: To summarize current evidence on post-TB vascular disease, including pathophysiology, clinical manifestations, diagnostic strategies, and gaps in management.
Methods: A targeted narrative literature review was conducted of peer-reviewed articles published between 2000 and 2025 using PubMed, Scopus, Google Scholar, and World Health Organization databases. Included studies were full-text English-language observational studies, case series, systematic reviews, meta-analyses, and guideline reports addressing post-tuberculosis vascular or cardiopulmonary outcomes. Articles unrelated to vascular sequelae or derived from non-scientific sources were excluded. No formal evaluation of the methodological quality of the included studies was performed.
Development: Post-TB vascular disease arises from parenchymal lung damage, fibrosis, vascular remodeling, and chronic inflammation. Pulmonary hypertension is commonly reported among TB survivors, particularly in individuals with recurrent disease, extensive fibrosis, or treatment default. Fibrosing mediastinitis, although rare, may result in significant vascular obstruction and superior vena cava syndrome. TB survivors may also face increased long-term risks of ischemic heart disease and stroke. Diagnosis typically requires a multimodal approach. However, standardized screening protocols and long-term epidemiological data remain limited.
Conclusions: Post-TB vascular disease remains largely overlooked and contributes substantially to long-term morbidity. Focused screening strategies, risk assessment, and ongoing follow-up are needed. Coordinated multidisciplinary research is essential to clarify disease burden, improve diagnostic approaches, and develop evidence-based interventions for TB survivors.
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