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the eportfolio in uk cardiology training: time for a new digital platform? haemorrhage with anticoagulants: risk reduction and reversibility. real-world experience of selexipag titration in pulmonary arterial hypertension. sarah cullivan, anandan natarajan, niamh boyle, ciara mccormack, sean gaine, brian mccullagh. selexipag is an oral selective prostacyclin-receptor agonist that was approved for use in patients with world health organisation (who). functional clas* ii–iii pulmonary arterial hypertension (pah). treatment with individualised doses of selexipag resulted in. significant reductions in the composite end point of death or a complication related to pah in the phase iii griphon (prostacyclin. titration and to establish the individualised maintenance regimens used in our centre, we performed this retrospective study of the first. 20 patients prescribed selexipag. baseline characteristics differed from the griphon study, with more combination therapy and. comorbidities at drug initiation. maintenance doses were stratified as low-dose in 10% (n=2), medium-dose in 70% (n=14) and high-dose in 20%. (n=4). this study highlights that selexipag can be safely initiated, titrated and transitioned in an outpatient setting to achieve an. acute takotsubo cardiomyopathy as a complication of transoesophageal echocardiogram. a 52-year-old woman, referred for transoesophageal echocardiography, developed acute takotsubo cardiomyopathy during the examination as a. result of emotional distress beforehand. asymptomatic left ventricular apical ballooning with severe systolic dysfunction within minutes of. this is an interesting case of wide complex tachycardia in a patient on flecainide for paroxysmal atrial fibrillation. diagnostic. possibilities were discussed, actual diagnosis revealed, and explanation provided. mengshi yuan, zafraan zathar, frantisek nihaj, stavros apostolakis, fairoz abdul, derek connolly, chetan varma, vinoda sharma. the coronavirus disease 2019 (covid-19) commonly involves the respiratory system but increasingly cardiovascular involvement is.