Pat Agnew, Executive Director, Pulmonary Hypertension Society.

I sympathize with doctors, particularly general practitioners. They are "frontline" diagnosticians who are expected to know every symptom and, even more challenging, every disease. When the patient comes in with generalized yet valid symptoms of exhaustion, breathlessness, dizziness, pain and edema, the detective work begins. We all know that in most instances these symptoms can be broken down and analysed and some common disease or syndrome can be diagnosed. However, there also are the few who show no evidence of abnormality in the testing process yet continue to come back with the same, sometimes worsening symptoms. These patients are usually sent to many specialists until a diagnosis is made or it is assumed, after appropriate work-up, that stress, obesity or an existing primary problem is the culprit.

Often, it is not until the patient is in serious trouble, possibly near death, that it is discovered that one of the rare, unusual afflictions is the cause of their often two- or more-year-old complaints. The goal of this article is to make clinicians aware of one of these diseases that, although not especially difficult to diagnose, is often missed because it is considered so rare--pulmonary hypertension. Presented are the modified contents of the brochure distributed by the Pulmonary Hypertension Society that is intended for patients and their families.