Is my Pulmonary Artery Pressure high?

[rhiannon353]

I am a 31 year old woman, in pretty good health overall.  I had an echocardiogram and was told by my Pulmonologist that I have Pulmonary Hypertension because my systolic PAP was 32 mmHg.  It also showed mild tricuspid regurgitation, trace mitral regurgitation, and the right ventricle appeared enlarged (but was not measured).  I was referred to a Cardiologist who said this echocardiogram was perfectly normal and there's nothing wrong with me.  I also have semi-frequent dypsnea, which is why I was seeing the Pulmonologist, but not other symptoms.  Should I trust the Cardiologist or go for a second opinion?  

Thank you for your time and any advice you can give me!
Brandi

[kenkeith]

I can give you some general information. The echo estimates the pulmonary artery pressure, and can either underestimate or overestimate the true pressure. The gold standard is the right heart catheterization. However when echos are done carefully by experience echo cardiographers the pressures estimated by echo usually correlate fairly closely to those obtained during cardiac catheterization.

Echos can also provide some additional useful information regarding size and function of the right ventricle, severity of leakage of the tricuspid valve. The mild and trivial leakage is medically insignificant and not considered any problem if the valves are structually normal.

A right heart catheterization which directly measures the pressures in the pulmonary arteries. This is recommended for everyone prior to receiving treatment for pulmonary hypertension. Prior to performing this test a number of non-invasive tests may suggest the diagnosis, including the electrocardiogram, chest x-ray and echocardiogram

...The 32 mm Hg is borderline high and considering the margin of error with an estimate: "Echo measurement is only an approximation of pulmonary artery pressure, however if correct an echo measurement estimating a pulmonary artery pressure of 50-60 mm Hg is far above normal. Therefore further evaluation is probably appropriate.
The gold standard test for diagnosing PH is a right heart catheterization which directly measures the pressures in the pulmonary arteries. This is recommended for everyone prior to receiving treatment for pulmonary hypertension. Prior to performing this test a number of non-invasive tests may suggest the diagnosis, including the electrocardiogram, chest x-ray and echocardiogram."...

A cardiac dyspnea (heart related) would cause shortness of breath by insufficient flow of blood to the system caused by inadequate pumping and/or improper filling.  Findings usually are left ventricle enlargement, etc.  That may be ruled out based on your information.

There can be expiratory dyspnea that is caused by a hindrance of free flow air from the lungs.  Also, respiratory distress can be associated with anxiety states. You may want to get another opinion from Pulmonologist, and slightly enlarged right ventricle may be secondary to pulmonary issues.

[Encephalomalcia]

I would get a second opionion being that the two differed.  Pulmonary hypertension is something that you want to catch early and being that you are having symptoms shows that there must be something going on.