Publications by authors named "Lea Harper"

Mentorship is now recognized as essential to the personal and professional development of physicians. Over the past decade, it has become a common theme in medical education literature, and through this our understanding of mentorship has evolved. Despite this progress, we believe that the prevailing reductionist view of mentorship is oversimplified and may hinder further advances in this space.

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Background: For medical training to be deemed successful, in addition to gaining the skills required to make appropriate clinical decisions, trainees must learn how to make good personal decisions. These decisions may affect satisfaction with career choice, work-life balance, and their ability to maintain/improve clinical performance over time-outcomes that can impact future wellness. Here, the authors introduce a decision-making framework with the goal of improving our understanding of personal decisions.

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During acute pulmonary embolism (PE) a compensatory increase in right ventricular (RV) contractility is required to match increased afterload to maintain right ventricular-pulmonary arterial (RV-PA) coupling. The aim of this study was to assess the prognostic utility of RV-PA decoupling in acute PE. We assessed the association between measures of transthoracic echocardiography (TTE)-derived RV-PA coupling including tricuspid annular plane systolic excursion (TAPSE)/right ventricular systolic pressure (RVSP) and right ventricular fractional area change (FAC)/RVSP as well as stroke volume index (SVI)/RVSP (a measure of pulmonary artery capacitance) with adverse PE-related events (in-hospital PE-related mortality or cardiopulmonary decompensation) using logistic regression analysis.

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As the demographics of congenital heart disease (CHD) have shifted, there are now more adults living with CHD than children in North America. This presents unprecedented challenges as patients with CHD acquire noncardiac comorbidities and seek care for a variety of reasons, including noncardiac surgery and emergency department (ED) visits. CHD shifts from a one organ problem to a multisystem disease and requires a team of specialists to maintain high-quality longitudinal care.

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Background: Initial combination therapy with an endothelin receptor antagonist (ERA) and riociguat in pulmonary arterial hypertension (PAH) has limited supporting data.

Methods: We performed a prospective, single-arm, open-label trial of riociguat, and ambrisentan for incident PAH patients in functional class III. The primary endpoint was pulmonary vascular resistance (PVR) at 4-months.

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Lung ultrasound (LUS) is a point-of-care ultrasound technique used for its portability, widespread availability, and ability to provide real-time diagnostic information and procedural guidance. LUS outperforms lung auscultation and chest X-ray, and it is an alternative to chest computed tomography in selected cases. Cardiologists may enhance their physical and echocardiographic examination with the addition of LUS.

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Background: Angiosarcoma involving the lung can represent either primary or metastatic malignancy. Due to the rarity of this condition, knowledge surrounding the natural history and clinical presentation is scarce. The aim of this scoping review is to summarize the existing literature on pulmonary angiosarcoma, particularly as it pertains to the clinical presentation and ancillary tests used for diagnosis in addition to histopathology.

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