#80 Pulmonary hypertension, freeways, and cows in heart failure

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 29 January 2018

⏱️ 63 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Pulmonary hypertension deconstructed with clinical pearls from cardiologist, John J. Ryan MD, FACC, FAHA, director of University of Utah Pulmonary Hypertension Center. We discuss classification, diagnosis/differentiation, initial workup, additional testing, echo findings, how to counsel patients with pulmonary hypertension, and why cows never get ankle edema!

Written and produced by: Jordana Kozupsky, NP and Matthew Watto, MD

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps:

00:00 Disclaimer
01:30 Introducing our new Correspondent Jordy
03:05 Listener feedback
04:40 Guest bio
06:25 Getting to know Dr Ryan
09:33 Picks of the week
15:20 Clinical case
16:35 How to explain pulmonary hypertension to a patient
18:12 Groupings of pulmonary HTN
21:20 Taking a history. Ask these questions.
23:30 Physical exam
25:45 Initial testing
27:40 Overnight pulse oximetry
29:00 Echo findings in pulmonary HTN
31:30 Transpulmonary gradient
33:33 What is a normal pulmonary artery pressure
35:15 Accuracy of PA pressure estimate by echo
39:04 Mechanism of shortness of breath in PH
40:10 Should you hold PAH meds in a hypotensive patient?
41:55 Therapy for PH and follow up
46:28 Who to refer
47:40 PAH risk factors
52:09 Mortality in PH
58:22 Take Home Points & Outro

Transcript

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0:00.0	The first signage podcast is for entertainment education and information processing.
0:09.1	As I've discussed, it should not be used only by industry, cure, or prevent any disease
0:11.6	or conditions.
0:12.6	For the more that you've used the same express podcast or solo dose, it should not be
0:14.1	interpreted perfectly for official policy or for the issue of any entity, the cyclopossil,
0:15.9	cash-like morons, and affiliate outreach programs.
0:16.9	Indeed, there are any defectors or none.
0:17.9	Pretty much we are responsible for this throughout, which we should always do our homework
0:18.9	and let's know when we work.
0:19.9	Welcome back to the Curbsiders.
0:35.9	Welcome back to the Curbsiders.
0:37.9	Hello, Matt.
0:38.9	It's been a while.
0:39.9	Hi, Stewart.
0:40.9	How's it here?
0:41.9	We have not recorded together in almost a month.
0:43.9	Yes.
0:44.9	Here, this is being released in 2018 and it is the first day of 2018.
0:50.0	I was purposefully avoiding all of your phone calls and text messages.
0:53.9	I think you actually sent me some mail, too.
0:56.4	You asked for my address.
0:57.4	It's kind of strange.
	...

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