Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of HIV-associated pulmonary arterial hypertension (PAH). Current symptoms include [dyspnea on exertion/fatigue/syncope/chest pain]. WHO functional class [I/II/III/IV]. Patient reports adherence to antiretroviral therapy (ART) and PAH-specific medications. No recent hospitalizations or changes in oxygen requirements.
Clinical Examination Findings
Cardiovascular: Regular rate and rhythm, prominent P2, systolic murmur at the left sternal border consistent with tricuspid regurgitation. JVD noted at [X] cm above the sternal angle. Extremities: [1+/2+] bilateral lower extremity edema, no cyanosis or clubbing. Lungs: Clear to auscultation bilaterally.
Treatment Protocol
Continue current ART regimen. PAH-specific therapy: [Endothelin Receptor Antagonist/PDE5 Inhibitor/Prostacyclin analogue] at [dosage]. Monitor for drug-drug interactions between ART and PAH medications. Schedule repeat 6-minute walk test (6MWT) and echocardiogram in [timeframe].