Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive exertional dyspnea, fatigue, and non-productive cough. History significant for endemic exposure to Schistosoma mansoni. Symptoms consistent with Group 1 Pulmonary Arterial Hypertension (PAH) secondary to hepatosplenic schistosomiasis. Denies syncope, chest pain, or orthopnea. Functional capacity assessed as WHO/NYHA Class [I/II/III/IV].
Clinical Examination Findings
Vitals: Tachycardia, tachypnea, SpO2 [Value] on RA. General: Signs of chronic liver disease (jaundice, spider angiomata, hepatosplenomegaly). Cardiovascular: Loud P2, right ventricular heave, holosystolic murmur at the left sternal border (tricuspid regurgitation). Pulmonary: Clear to auscultation. Extremities: Peripheral edema, no signs of DVT.
Treatment Protocol
Initiate PAH-specific therapy: [PDE5 inhibitor / Endothelin receptor antagonist / Prostacyclin analog]. Manage underlying Schistosomiasis with Praziquantel [Dosage]. Monitor liver function tests (LFTs) and right heart catheterization (RHC) parameters. Diuretic therapy as indicated for volume overload.