Elevated pulmonary pressure

[C.N.]

My husband wrote previously of his worries about my having elevated pulmonary pressure.  I went to see my e.p. doc, and asked him the reason for the elevation.  He said it was because of blood leaking backward around the pacer wires, tricuspid regurg., and this was indirectly causing my pulmonary pressure to be high.  I don't know it any of that makes sense, or if I'm saying it right, because I really didn't understand.

A little over a year ago, BEFORE my pacemaker was put in my echo said, mild tricuspid regurg., estimated PA pressure 44 mmHg assuming RA pressure of 10 mm Hg.

My questions are

A) I'm wondering if that result from one year ago shows elevated pressure, or if it is perfectly normal?

B)Does my doctor's explanation about the pacer wires causing the elevated pressures that I have now make sense?

C)Should the elevated pressure I now have be looked into further.
(All I saw on the echo report was mild pulmonary hypertension, not the current estimation?

D)Will the pressure continue to rise or is this it?

E)My doctor does not want me to have a right heart cath. because he said it would mess up my pacer wires and they would have to be repositioned.  Is this a good reason?

Thanks so much.  I know it's alot to ask, but I just want that 1% doubt that I have to be gone.  

[CCF CARDIO MD - DLB]

Your pressures were on the slightly high side to begin with. The pacer wires could interefere with your tricuspid valve, leading to leakage and this could raise the pressures in the heart. Such a mild degree of pulmonary hypertension would not generally warrant more investigation in the absence of symptoms. The pressure may rise in the future, if the degree of valve leakage increases. A right heart catheterization can be done in someone with pacer wires, but there is a definite risk of damaging the pacer wires. Therefore, probably best to avoid the catheterization unless there really is a concern about the pulmonary hypertension.