Internal Medicine

Pulmonary Vascular Disease

Questions discussed in this category

How would you manage symptomatic, bilateral subsegmental PE developed after long air travel?

The patient takes frequent flights, with no prior history of VTE, and has already been taking measures for prevention including frequent ambulation, h...

2 Answers available

In cases of intermediate-risk pulmonary embolism, what factors influence your decision to pursue catheter-directed thrombolysis?

1 Answer available

Have you noticed poor response to Tyvaso DPI compared to the nebulized form in PH-ILD?

Could the intrinsic inspiratory capacity and distribution of medication be different between the two routes?

1 Answer available

How would you manage a patient with morbid obesity who presents with new symptomatic pulmonary embolism a few days after he was started on DOAC for DVT?

What is your preferred anticoagulation in patients with BMI >50?

5 Answers available

How would you approach a pulmonary-renal PR3+ ANCA vasculitis patient who has persistent re-narrowing of mainstem bronchus after several dilatation and stenting procedures, with other anca features well-controlled on rituximab & avacopan?

5 Answers available

How do you manage concurrent nonlife-threatening hemoptysis and acute pulmonary embolism?

Estimating blood loss from hemoptysis is not always reliable. The bleeding may be due to the PE itself. Is anticoagulation with any degree of hemoptys...

1 Answer available

When do you consider the use of PH specific therapies in patients with pre-capillary pulmonary hypertension associated with sickle cell disease?

2 Answers available

How do you follow pulmonary embolism patients who have completed anticoagulation?

1 Answer available

What protective post-op measures do you recommend for a patient with scleroderma and a history of ILD, PH, Raynaud’s and digital ischemia undergoing cardiothoracic surgery?

1 Answer available

Do you obtain an echocardiogram as a part of risk stratification in all patients hospitalized with an acute pulmonary embolism?

2 Answers available

How do you determine if pulmonary hypertension is disproportionate to the severity of lung disease?

2 Answers available

How do you risk stratify patients with different WHO groups of pulmonary hypertension prior to non-cardiac surgeries?

And who would you not recommend to undergo surgeries?

1 Answer available

Do you consider pulmonary hypertension related to sarcoidosis to be an indication to start steroids?

Do you use biomarkers or PET scanning to stratify patients who may benefit most from therapy?

1 Answer available

How do you approach management of a patient with idiopathic PAH and +ANA, but no other current symptoms/signs of active rheumatologic disease?

3 Answers available

How long post operatively do you wait before transitioning from parenteral anticoagulation to oral anticoagulants after pulmonary thromboendarterectomy for CTEPH?

2 Answers available

Do you prefer using end-expiratory or mean pulmonary artery wedge pressure obtained during diagnostic right heart catheterization for the classification of precapillary vs postcapillary PH?

1 Answer available

When do you screen for pulmonary hypertension in ILD patients?

1 Answer available

What strategies do you employ to minimize the risk of cardiovascular collapse when intubating a patient with severe pulmonary hypertension?

Do you favor awake intubation in these cases?

2 Answers available

Do you recommend transfer to an institution with a PE response team for a patient with an intermediate risk PE?

1 Answer available

Would you place an IVC filter in a patient with an acute intermediate risk PE and a proximal DVT who is on anticoagulation?

1 Answer available

What is your approach to management of elderly patients with cardiopulmonary comorbidities and severe pulmonary hypertension?

1 Answer available

How would you treat a patient with combined pre- and post-capillary pulmonary hypertension after successfully optimizing post-capillary pressures through a valvular intervention?

2 Answers available

What is your approach to pulmonary vasodilator therapy in patients with COPD and Severe Group 3 Pulmonary Hypertension?

1 Answer available

Would you restart prophylactic anticoagulation in a patient with a history of unprovoked PE who received short term anticoagulation with a prior physician?

E.g. low dose DOAC

1 Answer available

Do you routinely use milrinone to augment RV function in patients with massive pulmonary emboli on vasoactive support?

1 Answer available

What is your approach to the management of a patient with PAH who is resistant to contraception and planning a pregnancy?

1 Answer available

What patient characteristics would lead you to opt for triple therapy versus double therapy in newly diagnosed PAH?

1 Answer available

How frequently do you monitor LFTs and CBC after initiating endothelin receptor antagonists?

Is there a difference in monitoring frequency for legacy drugs like bosentan vs newer agents (macitentan, ambrisentan)?

3 Answers available

Do you favor the use of Fick or thermodiluation to measure cardiac output in patients with interstitial lung disease with suspected pulmonary hypertension?

Occasionally, supplemental oxygen may alter Fick measurements giving falsely high CO and falsely low PVR, therefore is Thermodilution method preferred...

2 Answers available

When do you consider Balloon Pulmonary Angioplasty in patients with inoperable CTEPH?

1 Answer available

Do you consider extensive clot burden as a factor in determining whether patients with submassive PE may be appropriate for thrombolytic therapy?

3 Answers available

Do you consider the use of bevacizumab in patients with HHT who have high output cardiac failure related to liver AVMs who also have cerebral AVMs?

1 Answer available

Based on findings of the INCREASE trial, are you routinely prescribing inhaled treprostinil to patients with group 3 pulmonary hypertension secondary to interstitial lung disease?

1 Answer available

Are there patients who can forgo anticoagulation with asymptomatic, incidentally discovered subsegmental pulmonary embolism?

If there are a low-risk patients who can be monitored, how would you do so? If unprovoked, would you consider stopping anticoagulation?

2 Answers available