Applied Evidence

Shortness of breath: Looking beyond the usual suspects

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References

The 6-minute walk test is the best way to estimate prognosis and disease severity in patients with pulmonary arterial hypertension.

Treatment. Collaboration between primary and subspecialty physicians is usually recommended because PAH treatment requires advanced testing such as right heart catheterization or vasoreactivity testing. Research has shown anticoagulation with warfarin prolongs survival and improves quality of life.16 Oxygen may improve symptomatic control and should be started for anyone with saturation less than 90%.

Newer medications that target various pathways resulting in vasodilation include prostacyclin analogues (epoprostenol, iloprost, treprostinil), endothelin receptor antagonists (ambrisentan, bosentan), and phosphodiesterase type 5 inhibitors (sildenafil, tadalafil).14

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