A 3-year-old boy was brought into the office for vague abdominal pain of 5 days’ duration. His mother stated that he had had several episodes of nonspecific pain in the abdomen that lasted a few minutes and resolved spontaneously. More »
Forty-five percent of adults in the United States have hypertension, high serum total cholesterol levels, or diabetes, according to a recent report from the CDC.1 Of these persons, approximately 13% have 2 conditions and nearly 3% have all 3 (Figure 1). In nearly 15% of those with 1 of these... More »
A 68-year-old African American man presents for a checkup. He has had type 2 diabetes mellitus for the past 5 years but has no nephropathy and no history of cardiovascular disease. He is currently taking atorvastatin, 80 mg/d, and his low-density lipoprotein cholesterol level is 80 mg/dL. His blood... More »
I understand that patients with refractory hypertension have a high risk of obstructive sleep apnea (OSA) syndrome. Can this be screened for in an office setting? More »
Pulmonary arterial hypertension (PAH) may lead to increased pulmonary vascular resistance, compromised vasoreactivity, right heart failure, and death. PAH, a subset of pulmonary hypertension (PH), classically is associated with systemic sclerosis but also occurs with other rheumatologic conditions.... More »
Despite the recent development of several new therapies, pulmonary arterial hypertension (PAH) remains an incurable disease. Careful monitoring of disease progression is vital to ensuring that patients receive maximal medical therapy before the onset of overt right-sided heart failure. In part 1 of... More »
Careful monitoring of disease progression is vital to ensuring that patients with pulmonary arterial hypertension receive maximal therapy before the onset of overt right-sided heart failure. Routine follow-up includes the evaluation of symptoms, functional class, and exercise capacity... More »
A 77-year-old man of Japanese ancestry with a history of well-controlled hypertension was seen in the morning for a routine examination. His blood pressure was normal as were the results of a complete blood cell count and liver function tests. About 6 hours later, he presented to the emergency... More »
Survival is reduced significantly in patients who have systemic sclerosis (SSc) with pulmonary hypertension (PH) combined with advanced interstitial lung disease (ILD) compared with patients with SSc who have isolated pulmonary arterial hypertension (PAH). The prognosis for patients in the former... More »
