The Curbsiders Internal Medicine Podcast #80 Pulmonary hypertension, freeways, and cows in heart failure
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Jan 29, 2018 Dr. John J. Ryan, a prominent cardiologist and director of the University of Utah Pulmonary Hypertension Center, dives into the complexities of pulmonary hypertension. He shares invaluable clinical pearls on diagnosing and managing this condition. The conversation highlights the fascinating reasons why cows don’t get ankle edema, along with key diagnostic tests and echocardiogram findings. Ryan explains how to best counsel patients and emphasizes the importance of understanding various risk factors and treatment options in pulmonary hypertension management.
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History Questions for Pulmonary Hypertension
- Ask patients if they can walk as far as they want and how far they can walk.
- Inquire about when they were last completely well, syncope, and angina.
Physical Exam Findings
- Physical exam findings for pulmonary hypertension include palpable P2, right ventricular heave, and loud P2.
- Look for signs of right heart failure such as elevated JVP, ascites, enlarged liver, and peripheral edema.
Initial Workup for Pulmonary Hypertension
- Start with EKG, PFTs, chest x-ray, and overnight oximetry for suspected pulmonary hypertension.
- If these tests reveal a diagnosis, you're done; if not, or if the patient is very ill, consider more advanced testing.
