Shortness of breath: Looking beyond the usual suspects
COPD and pneumonia come to mind when a patient is short of breath. But the signs and symptoms detailed here should lead you to suspect an uncommon cause.
Treatment. Collaboration between primary and subspecialty physicians is usually recommended because PAH treatment requires advanced testing such as right heart catheterization or vasoreactivity testing. Research has shown anticoagulation with warfarin prolongs survival and improves quality of life.16 Oxygen may improve symptomatic control and should be started for anyone with saturation less than 90%.
Newer medications that target various pathways resulting in vasodilation include prostacyclin analogues (epoprostenol, iloprost, treprostinil), endothelin receptor antagonists (ambrisentan, bosentan), and phosphodiesterase type 5 inhibitors (sildenafil, tadalafil).14
