I had an echocardiogram done 2 days ago which sowed that I have borderline mild mitral valve prolapse with no regurgitation. My dr assured me that my heart is completely healthy, strong and normal size and the MVP is nothing to worry about. Then he told me I have something called “Mild pulmonary hypertension” with a pulmonary artery systolic pressure of about 38 mmHg. I’ve been doing research on the internet I am really getting scared. It seems this desease is very fatal. Should I be worried? I am a 25 years old female and thin (115 lbs). I’ve never smoked, taken diet pills, drugs, etc. Since my heart is healthy and they caught this early, do I still have a chance? Please help!
The pulmonary artery systolic pressures derived from a transthoracic echocardiogram are estimates based on the Bernoulli equation which uses with peak velocity from tricuspid regurgitation to estimate right ventricular systolic pressure. Normal values are less than 30 mmHg at rest, and your value is only mildly elevated at 38 mmHg. The point is that these are derived values and may vary as much as 5 to 10 points from examination to examination. To get an actual direct measurement you would need to undergo what is known as a right heart catheterization, where a catheter is placed in a pulmonary artery and pressures can be measured. The other advantage from this procedure is that it can detect small amounts of shunts (communications between the left and right sides of the heart which can cause increased flow to the lungs and consequently pulmonary hypertension). One particular type of her shunt can be detected by transthoracic echocardiogram with the use of air bubbles, but but I am not sure this was used. If in fact he do have pulmonary hypertension based on right heart catheterization, one should obtain a review of systems searching for secondary causes of pulmonary hypertension: Asking about joint pain, muscle aches, finger or lower extremity pain or numbness and change in color. Also an extensive pulmonary review of systems including chronic pneumonias, tuberculosis exposure, risk factors for cystic fibrosis and others which can cause a pulmonary hypertension.
As far as prognosis does your mistaking your problem for primary pulmonary hypertension (PPH) which does affect people in your age group and has a bad prognosis with any treatment that we have. However those patients usually have much higher pressures than you do, at least by the time they become symptomatic. This problem is a primary problem of the pulmonary vessels, and to make its diagnosis one must exclude all cardiac, systemic, pulmonary causes which may be reversible.
I recently had the same type of echo report and it is scaring me too. My doctor didn't even inform me of the mild pulmonary hypertension. I asked for a copy of my report and saw it on there. My pressure was 33mmhg.with mild tricuspid regurgitaion I am scared because i have been having stomach pain and shortness of breath sometimes. Have you gone back and asked the doctor or cardiologist who reads the echo? Let me know what you find out.
Many people going in for echos are finding numbers like this. The actual diagnosis of pulmonary hypertension needs to be confirmed by right heart cath. Furthermore you would need other signs including enlarged RV and dilated pulmonary artery. For example, I too have 33 mmhg estimated but was never noted as pulmonary hypertension. I also have mild tricuspid insufficiency (very normal in the population) stating the fact that some odd 50% of the population has this... then would equate to having elevated pulmonary pressures. The ones that seem to push for further testing (right heart cath) will find their pressures were indeed normal. I had read at some point that the cutoff for pulmonary hypertension was raised to 40 mmhg but I cannot find that statement anymore. It had read that "Since mild tricuspid regurgitation is found so often in the general population, the maximum cutoff has been raised" but I cannot confirm so unless a doctor can provide that reference from the AHA or another viable source... dont quote anything I say.
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