Mild Pulmonary Hypertension

[DaveSC]

I had an EKG done at a health fair early this year.  My overall risk was assessed at Low for cardio problems but they noted "possible LVH". I am aware that they can get bad (false positive) results due to a number of reasons. So at my annual physical I passed along that info to my doctor. He said to be safe he'd have me get an echocardiogram. Without going into all the details of the results the conclusions were : (1) Normal left ventricular systolic function (2) No evidence of LVH (3) Mild tricuspid regurgitation with mild pulmonary hypertension. They noted the peak RVP of 36 mmHg. The report states that is an "estimated" number. Can there be error in that estimate? If so, how much can the error be? I've looked up some of the symptoms of this and found: tiredness, difficulty in breathing, dizziness or fainting, swelling in ankles or legs, chest pain, palpitations, etc. I am a 55 year old married male, seemingly very healthy and quite active.  I've been running almost 30 years and have run 35,000 or more miles in that time. I have had none of the above symptoms nor have I ever had exercise intolerance having run everything from 5 mile races to a marathon over the years. I currently run 5-6 miles per day 5 days per week.

My questions are:

(1) With the "estimated" number above are false positive readings possible?
(2) I can find very little info on if this "mild" form (assuming I have this) progresses to a more severe form. Is there any info on if/how this progresses and how concerned should I be?
(3) I don't see much info on treatment options. Or is a mild form something to merely monitor?
(4) Are there any lifestyle changes to make? As stated I run, bicycle, kayak, do some weight training and eat very healthy.
(5) My internal medicine doctor didn't seem overly concerned and suggested I might have another echo in a year or so.  He did say I may want to consider some pulmonary testing to see if there is any lung disease. Part of me thinks if I had lung issues I'd not be capable of running 6 miles at a time with no breathing problems.

[Cka000]

Hi Dave I just wanted to see how you're doing your story sounds similar to mine and I wanted to find out how you're doing today

[DaveSC]

Thanks for the replies. The little info I've found online seems to be all over the map. It seems as if there's a bit of subjectivity in how a cardiologist may interpret the numbers. For example I found one case where someone had a 40 mmHG and was diagnosed as "borderline" for pulmonary hypertension. Mine was 36 mmHG and diagnosed as "mild" pulmonary hypertension. I also have concluded that any doctor would most likely want to error on the safe side (given the malpractice suits that people file).

The reason I'm trying to get to the bottom of this is because this "mild pulmonary hypertension" was the sole reason for me being rejected for health insurance recently.  No other issues, I'm not on any medications, etc.

I did read that systemic hypertension can possibly be a cause of mild pulmonary hypertension. Does anyone know if that's accurate? I have had "white coat syndrome" for a long time -- get me within a mile of a doctor's office and my BP climbs. On the other hand I donate platelets monthly at my local Red Cross and looking at my donation card my last 14 visits show an average of 119/80 for BP.

I'm going to try to get a few answers from the cardiologist who interpreted my echo results. Seems as if an echo can produce false positives and the only other option is a catheterization which I'm sure costs quite a bit more and something I don't really want to pursue at this time.

[markmsn10]

You are correct that this is just an "estimate" because it is based off of tricuspid regurgitation jet.   Upwards of 50% of normal people have mild tricuspid regurgitation of no significance.    The diagnosis of any pulmonary hypertension would be more likely if there were enlargement of the right atrium and ventricle.  

I also had pulmonary pressures on the higher side but was never told of anything... I just happen to see it on the echo report I had 5 years ago (I've yet to go back in since I was told not to worry about it)

[Encephalomalcia]

The mild regurgitation is probably normal for your age.  I was 43 when one of my valves had regurgitation and the doctor said that was normal for my age.  The pulmonary hypertension is something to question about.  Hypertension is not good and is bad for your heart and lungs.  You should get the lung testing done.  You may have just got used to some pressure because it came on slowly.  You may not notice it, but it is there.  Kind of like when you don't know your eyesight is that bad until you get the glasses.