Pulmonary Hypertension
Three cases on pulmonary arterial hypertension drug selection and escalation strategy — choose a case below to open its full multi-voice debate.
Fourteen months into treatment, her numbers show she's winning. Whether her symptoms match depends on which functional class you believe — and the two readings point toward genuinely different next steps.
A single patient, six months into first-line combination therapy for idiopathic pulmonary arterial hypertension, improving by some measures and not at all by others. The disagreement is whether that mixed result is reason enough to repeat an invasive test before choosing the next drug, or reason enough to choose it without one.
Her PAH isn't responding to sildenafil, and the drug shown to help in exactly this situation cannot be given alongside it. The question is whether her kidneys make the switch itself riskier than staying inadequately treated.