In the final part of this series, Joseph Parambil, MD, walks us through the approach of managing pulmonary hypertension, reviews the pathophysiology and digs into the mechanisms and the differences in the medications.

• Intro 0:12
• In this episode 0:17
• Interview with Joseph Parambil, MD 2:53
• Reviewing and clarifying pathophysiology prior to initiating therapeutics 4:13
• Evaluating patients in terms of their functional status and how does that play a role in initiating therapies 4:25
• Vasoreactivity testing 10:21
• The categories of medications 14:40
• Endothelin receptor antagonists 37:07
• TGF pathway 42:13
• Scleroderma patient and treatment 50:19
• Do patients get a repeat right-heart catheterization? 55:51
• What about the TGF-beta? 56:55
• Thank you, Dr. Parambil 58:34
• Thanks for listening 59:17

We'd love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.

Disclosures: Brown and Parambil report no relevant financial disclosures.

Joseph Parambil, MD, is a staff member in the Respiratory Institute and the director of the HHT Center of Excellence and the Vascular Anomalies Center at the Cleveland Clinic. He is associate professor of medicine at Cleveland Clinic's Lerner College of Medicine. He is certified by the American Board of Internal Medicine with additional specialty certification in pulmonary medicine and critical care medicine.