In the Clinic

What is In the Clinic?

"In the Clinic is a monthly feature in Annals of Internal Medicine introduced in January 2007 that focuses on practical management of patients with common clinical conditions. It offers evidence-based answers to frequently asked questions about screening, prevention, diagnosis, therapy, and patient education and provides physicians with tools to improve the quality of care.

The foundation for In the Clinic is the evidence-based clinical guidance in the American College of Physicians' electronic point-of care decision-making resource, PIER (Physicians Information and Education Resource pier.acponline.org). In the Clinic integrates this material on broad topics in a relatively brief, easy-to-read format with an emphasis on practical measures that can be readily integrated into practice."

May 07, 2013

Pulmonary Hypertension

Jess Mandel, MD; and David Poch, MD

The pulmonary vascular bed is normally a low-resistance, high-capacitance circuit capable of accommodating the entire cardiac output at pressures approximately 15%–20% of those in the systemic circulation. In pulmonary hypertension (PH), elevated pulmonary arterial pressure places a burden on the normally thin-walled right ventricle as it works to maintain normal blood flow. Without effective therapy, right heart dysfunction leads to progressive symptoms and is often fatal. Pulmonary hypertension is frequently a result of common left-sided heart or lung diseases. Less frequently, it results from a disease process intrinsic to the pulmonary vasculature itself. Differentiating among the several causes of PH requires methodical evaluation. Differentiation is essential because management varies according to the underlying cause, and misapplication of therapy can cause serious harm.

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5 May 2009

Abdominal Aortic Aneurysm