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Being a Physician Assistant in the Pulmonary Hypertension Arena

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Julia Estes MPAS PA-C
Chief Physician Assistant
Advanced Heart Failure and Pulmonary Hypertension
Allegheny Health Network
Pittsburgh, PA, USA

It was about 3 years ago that I took the position of being a heart failure/pulmonary hypertension Physician Assistant (PA) at Allegheny General Hospital, Pittsburgh, PA. Although the time at AGH has been short, it has been filled with remarkable experiences. Our team specializes in advanced heart failure, pulmonary hypertension, mechanical circulatory support and cardiac transplantation. One of the areas in particular, pulmonary arterial hypertension (PAH), has always been fascinating. PAH is a relatively rare disease process, which has seen an explosion in terms of changes in understanding pathophysiology and treatment in the last decade. Three new medications were approved for the treatment of PAH this last year and many more novel therapies are available to our patients via clinical research trials. Being a part of this rapid and progressive change in medicine is thrilling as it is literally happening in front of our eyes!

The program would not succeed without a team-based approach to PAH patients. PAs serve as liaisons between the many facets of our group, working very closely with world-renowned physicians and surgeons, as well as dedicated PH pharmacists and nurse coordinators. One of the most important aspects of our team includes constant communication amongst one another, who have dedicated our lives to this disease and our patients. In rare diseases like PAH, communication is vital, and PAs guide patients' transition from inpatient to outpatient by relaying detailed information to the nurse coordinators and partaking in direct patient care. It is a large responsibility for us to educate patients regarding their disease state and medications. In particular, when a PAH patient is newly started on a prostacyclin, there is a lot of counseling that is involved with an admission and discharge. PAs are also integrated into several clinical research projects that will hopefully shape the future of PAH treatment. The role of the PA includes screening and patient recruitment, communicating with research coordinators and physicians, and representing the institution at national PAH and related conferences like the upcoming ISHLT meeting in San Diego in April 2014.

Management of PAH is difficult as patients may seem well but are truly quite ill. Juxtaposed against the awe of PAH, is a truly humbling experience. I have sat with our patients and listened to stories about how their diagnosis has irrefutably changed their lives. Their gratitude for anything that can be done to extend and improve their lives is immeasurable. Bearing witness to their struggles only encourages us to work harder toward advancements in this disease. I feel honored to be a part of a team and the ISHLT that give so much to what is in the best interest of patients with PAH Being a PAH Physician Assistant cannot be summed up in the words above, but the best description for this career is exceedingly and indescribably rewarding.

Disclosure Statement: the author has no disclosures.

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