Doctors not treating my Pulmonary Hypertension

I have right heart failure and pulmonary hypertension, which appears to be primary.  Also dx'd with cor pulmonale.  I am taking heart failure protocol -- aspirin, ace inhibiter, beta blocker, diuretics, nitroglycerin, imdur, etc., along with oxygen and CPAP at night -- though I do not have significant sleep apnea.  I do desat to 80% O2 at night.

Anyway, I have dizziness, vasomotor angina, some days I have to call off work because I nearly fall over every couple of steps, sob on exertion always, somtimes with very little exertion.

I am not taking anything for the pulmonary hypertension and this concerns me.  My cath in July 2006 showed PAP to be 40 -- Echos in 9/2007 showed 40.2 and 7/2008 showed 45.  My pressure is creeping up and I have symptoms that cause me a lot of trouble, especially in the winter time or barometric pressure change.  My doctors don't seem to want to treat my PH.  Should I see a specialist out of state?  

[maggiemag]

Did your right heart cath show a mean pressure of 40 or was it the systolic pressure.  A mPAP over 25 is considered PH but a systolic of 40 would not.  It seems you might have left heart issues as well judging by the beta blocker, NTG and  the Imdur.  If your right heart pressures are elevated due to left heart problems,then the treatment is for the left heart problems.  Was your wedge pressure elevated on the RHC?  It would be listed as PCWP, and if elevated, indicates left heart issues causing back up right heart issues.  Do you have COPD also?  I am not familiar with the term vasomotor angina.
The bottom line, imo,  is that you need to see a PH specialist, if only to determine if the problem is really the left heart.  You might have to travel out of state.  Where do  you live?