- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Importance of Early Detection and Monitoring for Disease Progression
Panelists discuss how early detection barriers include nonspecific symptoms like progressive dyspnea that are often misattributed to more common conditions, leading to delayed diagnosis and the need for improved diagnostic algorithms using biomarkers and imaging.
EP: 1.Pathophysiology of Pulmonary Arterial Hypertension
EP: 2.Differential Diagnosis of Pulmonary Arterial Hypertension
EP: 3.Importance of Early Detection and Monitoring for Disease Progression
EP: 4.Risk Stratification and the Importance of Patient-Centered Care
EP: 5.Strengths and Limitations of Current Therapeutic Options
EP: 6.Overview of Different Therapies for Patients with Pulmonary Arterial Hypertension
EP: 7.Sotatercept for Patients with Pulmonary Arterial Hypertension
EP: 8. The Role of the Prostacyclin Pathway
EP: 9.Important Clinical Considerations for Pulmonary Arterial Hypertension
EP: 10.Economic Impact of Pulmonary Arterial Hypertension
EP: 11.Barriers to Care for Patients with Pulmonary Arterial Hypertension
EP: 12.Utilizing Health Economic Outcomes in Clinical Practice
EP: 13.Outlining the Need for Equitable Access to Care
EP: 14.Final Panelist Thoughts on the Management of Pulmonary Arterial Hypertension
Clinical Presentation and Symptom Recognition
Early symptoms of pulmonary arterial hypertension are typically subtle and nonspecific, leading to frequent diagnostic delays and misdiagnoses. Progressive dyspnea on exertion represents the most common initial symptom, accompanied by fatigue and rapid exhaustion during physical activity. More severe symptoms like syncope and peripheral edema typically occur later in disease progression, often indicating advanced right heart dysfunction and poor prognosis.
The nonspecific nature of early PAH symptoms contributes to diagnostic challenges, with patients often experiencing months or years of evaluation by multiple physicians before receiving an accurate diagnosis. Recent European guidelines have introduced screening algorithms for general practitioners, incorporating ECG and biomarker measurements (BNP or NT-proBNP) to identify patients who warrant echocardiographic evaluation. While these tools lack perfect sensitivity, they provide valuable screening capabilities for symptomatic patients.
Improved diagnostic approaches emphasize the importance of reassessing patients who fail to respond to initial treatments for more common conditions like asthma or COPD. When patients continue experiencing unexplained dyspnea despite standard therapy, further evaluation becomes essential. This systematic approach, combined with increased awareness among healthcare providers, aims to reduce diagnostic delays and facilitate earlier referral to specialized pulmonary hypertension centers.
Integrated Care for Chronic Conditions: A Randomized Care Management Trial
December 3rd 2025The authors sought to understand the differential impact of payer-led community-based care management approaches on stakeholder-oriented outcomes for publicly insured adults with multiple chronic conditions.
Read More
Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
Read More
