Noah

Hey, everyone.

I'm doing pretty good.

Yesterday was my partner's first day at her new job.

So I'm excited to kind of, I'm waiting for her to get home so she can tell me everything that happened and all that.

So excited for that.

What about you, Yusuf?

You know, that's a great introduction to the case.

And I have learned this factoid during my ICU rotation that patients with pulmonary hypertension, they have to avoid doing Valsalva.

And the reason behind it is kind of the same reasoning why we are so hesitant in using positive pressure to ventilate those patients.

which is to increase their anthrothoracic pressure and then kind of reduce their preload.

And they're very preload state dependent with the pulmonary hypertension and the likely right-sided heart failure.

So it's very good that she...

valsalva and syncope in the clinic where there are people able to help her.

And I'm very worried because to me, that's a marker of pretty advanced disease.

Of course, we have to do our due diligence and kind of exonerate other causes of syncope.

But I think for me, that would be a

Pretty convincing story for severe pulmonary hypertension causing syncope with increased intrathoracic pressure.

What do you think so far, Mark?

Actually, Yusef, I don't think about pulmonary hypertension in an anatomical way.

I have a much more pragmatic approach of pulmonary hypertension because I have found that, we'll talk about this in further other quotes, but the way we classify pulmonary hypertension is in the WHO groups, so group one through five, and that's kind of based...