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Heart Disease (Expert Forum)
Pulmonary Hypertension
Answered by
Cleveland - OH
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Pulmonary Hypertension
by MBT, Jan 30, 2005 12:00AM
Thank you. Had an ECG 1/05; also one 11/04 when admitted to hospital with SOB and low BP. Also pulmonary function test in 12/04. Would appreciate knowing what it all means. Please explain the difference between the two ECGs and conclusion given on the PFT. Have omitted normal results. I take CCB+325mg aspirin daily since Dec; previously Atenolol 25mg.
1/05 ECG:
Mitral valve thickened w/o restriction. Moderate (2+) mitral regurgitation
Right ventricle mildly dilated. Mild right ventricular hypertrophy.
Right atrium mildly dilated
Tricuspid valve thickened w/o restriction. Mild (1+) tricuspid regurgitation. Estimated pulmonary artery systolic pressure is 55 mmHg
No pericardial effusion or intracardiac shunts
IMPRESSION:
Moderate mitral regurgitation
Mild tricuspid regurgitation
Mildly dilated and hypertrophied right ventricle
Moderate pulmonary hypertension
11/04 ECG:
Mild mitral regurgitation. Mitral valve appears anatomically normal.
Right atrium: normal
Tricuspid valve: trace tricuspid regurgitation. Estimated pulmonary artery pressure is 68 mmHg. Moderate pulmonary hypertension
12/04 PFT
Mild restrictive ventilatory defect. Question if this is related to her body habitus/obesity (noted height of 64 inches and 134 pounds). Also noteworthy: diagnosis given for complete PFT - pulmonary hypertension - question findings related to same. Clinical correlation is suggested.
Abnormal at rest arterial blood gas and pH determination with evidence of moderate hypoxemia. PaO2 was 26 mmHg less than that calculated for her age & position.
MBT
1/05 ECG:
Mitral valve thickened w/o restriction. Moderate (2+) mitral regurgitation
Right ventricle mildly dilated. Mild right ventricular hypertrophy.
Right atrium mildly dilated
Tricuspid valve thickened w/o restriction. Mild (1+) tricuspid regurgitation. Estimated pulmonary artery systolic pressure is 55 mmHg
No pericardial effusion or intracardiac shunts
IMPRESSION:
Moderate mitral regurgitation
Mild tricuspid regurgitation
Mildly dilated and hypertrophied right ventricle
Moderate pulmonary hypertension
11/04 ECG:
Mild mitral regurgitation. Mitral valve appears anatomically normal.
Right atrium: normal
Tricuspid valve: trace tricuspid regurgitation. Estimated pulmonary artery pressure is 68 mmHg. Moderate pulmonary hypertension
12/04 PFT
Mild restrictive ventilatory defect. Question if this is related to her body habitus/obesity (noted height of 64 inches and 134 pounds). Also noteworthy: diagnosis given for complete PFT - pulmonary hypertension - question findings related to same. Clinical correlation is suggested.
Abnormal at rest arterial blood gas and pH determination with evidence of moderate hypoxemia. PaO2 was 26 mmHg less than that calculated for her age & position.
MBT
Doctor's Answer
by Cleveland Clinic, Jan 30, 2005 12:00AM
, Jan 30, 2005 12:00AM
MBT,
The result you provide are from an echo, not ecg.
The concerning primary problem revealed in the data you provide is the diagnosis of pulmonary hypertension which means that you have elevated pressures in blood vessels that move blood from the right side of your heart to your lungs. On the last echo, this pressure elevation this has caused changes in the ventricle that has resulted in dilation of the right side of the heart.
The PFTs show that your lungs do not expand as well as they should meaning they have some restriction. There are a lot of factors that can cause this such as obesity and intrinsic lung disease. The PFTs are only a marker of this. The blood gas basically states the same non specific thing.
The bottom line is this is a concerning diagnosis. There are multiple causes of pulmonary hypertension. The basic way I break it down is that problems with the heart (such as valve disease), problems with the lungs (such as sleep apnea and pulmonary fibrosis) and problems with the blood vessels themselves (such as with scleroderma and vasculitis) can all cause pulmonary hypertension. These are known as secondary causes and fixing the underlying cause can often stave off the progression of the disease. Primary pulmonary hypertension is a diagnosis in itself, after all other causes have been ruled out, with specific modalities of therapy.
There is a very straightforward evaluation of pulmonary hypertension. At this point I would seek a cardiologist or pulmonologist skilled in treating patients with pulmonary hypertension for your care and diagnosis.
good luck
The result you provide are from an echo, not ecg.
The concerning primary problem revealed in the data you provide is the diagnosis of pulmonary hypertension which means that you have elevated pressures in blood vessels that move blood from the right side of your heart to your lungs. On the last echo, this pressure elevation this has caused changes in the ventricle that has resulted in dilation of the right side of the heart.
The PFTs show that your lungs do not expand as well as they should meaning they have some restriction. There are a lot of factors that can cause this such as obesity and intrinsic lung disease. The PFTs are only a marker of this. The blood gas basically states the same non specific thing.
The bottom line is this is a concerning diagnosis. There are multiple causes of pulmonary hypertension. The basic way I break it down is that problems with the heart (such as valve disease), problems with the lungs (such as sleep apnea and pulmonary fibrosis) and problems with the blood vessels themselves (such as with scleroderma and vasculitis) can all cause pulmonary hypertension. These are known as secondary causes and fixing the underlying cause can often stave off the progression of the disease. Primary pulmonary hypertension is a diagnosis in itself, after all other causes have been ruled out, with specific modalities of therapy.
There is a very straightforward evaluation of pulmonary hypertension. At this point I would seek a cardiologist or pulmonologist skilled in treating patients with pulmonary hypertension for your care and diagnosis.
good luck
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(I am on bisoprolol and verapamil ER for IST and NCS. I see cardio ep every 6 mos.)
I am wondering too, if it is coincidental that both parents had emphysema later in life and neither ever smoked. I can think of reasons why ea. might had developed it, but wonder if it's anything.
Anybody know?
The emphysema in your parents may be something you need to keep in mind but if you don't have any lung disease, I wouldn't worry about it too much and just check in with your primary MD periodically for an exam.
Connie