Preview Mode Links will not work in preview mode

The Curbsiders Internal Medicine Podcast

Supercharge your learning as these board-certified Internists interview the experts to bring you clinical pearls, practice changing knowledge, and a healthy dose of humor. 

Jan 29, 2018

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

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at

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
  • 60:24 Outro

Tags: pulmonary, arterial, hypertension, group, classification, prognosis, pressure, blood, diagnosis, treatment, pay, ph, echocardiogram, ekg, hypoxic, chronic, lung, disease, heart, left, right, failure, chf, pressure, mean, diuretic, HFpEF, cteph, embolism, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student