title: The initial 18 months of the first multi-disciplinary regional Pulmonary Arterial Hypertension Clinic in Australia.
abstract: OBJECTIVE
  To report the initial 18 months experience of the first multi-disciplinary regional Pulmonary Arterial Hypertension (PAH) Clinic in Australia.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Community setting on the mid-north coast of New South Wales.
  
  
  METHODS
  A total of 47 patients (mean age±standard error of the mean: 71.8±1.8 years; male/female ratio 13/34).
  
  
  METHODS
  Diagnosis of PAH, exclusion of other causes of pulmonary hypertension, commencement of PAH-specific pharmacotherapy.
  
  
  RESULTS
  Twenty-three (49%) patients were discharged back to their GP with pulmonary hypertension from a combination of ischaemic heart and/or lung disease. Three (6%) patients died from connective tissue disease (CTD)-related PAH with one death (2%) from ischaemic heart disease. Five (11%) patients remain on treatment (n=2, Bosentan for congenital heart disease-related PAH; n=1 Bosentan for CTD-related PAH; and n=1 Bosentan and n=1 Sildenafil for primary PAH). Fifteen (32%) patients have ongoing review for PAH related to CTD (n=11), carcinoid (n=1) and uncertain cause (n=3).
  
  
  CONCLUSIONS
  Patients with CTD-related PAH have a poor prognosis. PAH should be considered in anyone with dyspnoea without obvious features of cardiac or pulmonary disease, especially in the setting of a CTD. Regional population centres are under-resourced with PAH specialty medical services. We have sought to address this by establishment of the first regional multi-disciplinary PAH Clinic in Australia.
authors: Mid-North Coast Arthritis Clinic, Coffs Harbour Health Campus, St Vincent's Hospital, Sydney, NSW 2450, Australia.
authors: Hanish
authors: H
authors: Bagga
authors: Karen S W
authors: KS
authors: Chia
authors: Diane
authors: D
authors: Freeman
authors: Lyn
authors: L
authors: Hales
authors: David S
authors: DS
authors: Henderson
authors: Eugene
authors: E
authors: Kotlyar
authors: David
authors: D
authors: Law
authors: Pradeen
authors: P
authors: Mudholkar
authors: Cheryl
authors: C
authors: Tulk
authors: Jon H
authors: JH
authors: Waites
authors: Peter K K
authors: PK
authors: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D015331:Cohort Studies; D003153:Community Health Services; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D019982:Organizational Case Studies; D011446:Prospective Studies