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Targeted History For Suspected PH
- When evaluating unexplained dyspnea ask timing, exertional vs rest, cough, orthopnea, leg swelling, and connective-tissue symptoms.
- Screen for liver disease, thyroid disease, HIV, rheumatologic signs, and family history to identify causes.
Physical Exam Clues That Point To PH
- On exam look for tachycardia, loud P2, TR murmur and jugular venous distension with large V waves.
- Use exam clues like telangiectasias or Raynaud's to suggest specific etiologies.
Essential First-Line Tests
- Initial outpatient screening should include chest X-ray, ECG and transthoracic echocardiogram.
- Add CBC, platelets, LFTs, TSH, HIV and hepatitis serologies as baseline screening tests.