Symptom Onset and Diagnosis
13 Minutes
READ
Teresa has been an elementary school teacher for over 20 years. She is single and has no children, but has been dedicated to the students she teaches and loves her career. In her free time she enjoys reading and going on long walks with her dog, Zorro.
For the past six months or so, Teresa has become more aware of some health problems that are increasingly disruptive to her life.
Teresa Reyes
Patient
She/Her
LISTEN
Let’s listen to our patient, Teresa, as she describes how she first began to notice and grow concerned about her health problems.
REVIEW
Let’s review the timeline of Teresa’s diagnostic tests that ultimately led to her Pulmonary Arterial Hypertension (PAH) diagnosis.
3 Minutes
Symptom onset
Delays visit to PCP
Symptoms worsen
Runs out of breath doing simple tasks at home and at school
Visits PCP for the first time
- Shares her symptoms with doctor
- Routine labs and tests obtained along with pulmonary function test. No acute findings.
Misdiagnosis of exercise-induced asthma
HCP prescribes inhaler due to results of spirometry test
Symptoms worsen, revists PCP
- Transthoracic echocardiogram shows right cardiac pressure is high
- Referred to pulmonologist
Visits pulmonologist
- Full cardiac workup
- Repeat echocardiogram
- Blood work and labs, evaluating fluid balance
New misdiagnosis of congestive heart failure
- High BNP indicates congestive heart failure
- Prescribed a diuretic and told to continue inhaler
Symptoms worsen
- More dizziness and marked limitation with any normal function
- Patient remains at functional class 3
- Right heart catheterization ordered
Right heart catheterization performed
Diagnosed with PAH
Pulmonary arterial hypertension, a rare form of pulmonary hypertension, occurs when the walls of the arteries leading from the right side of the heart to the lungs narrow and tighten.
REFLECT
Read the questions below and discuss them as a group. Then, type in your reactions in the fields provided.
Consider the patient's perspective:
6 Minutes
Teresa Reyes
Patient
She/Her