Mild pulmonary hypertension

[osiag]

I have had serial echos since 2001 to watch mild AI. I have noted that the est. PA sys pressure was mildly elevated (30-35) on the last echo.  Over the years the est. PA sys pressures were 30 (2001), 25 (2002), 20-25 (2003), 25-30 (2004), and 30-35 (2005).  Not much of a trend since it starts at 30 in 2001.  My cardiologists notes that the echos are essentially the same in all regards over the years.  Here is my 2005 echo:  Left atrium =4.2, LVED =5.0, LVES =2.9, IV septal thickness =11, LV posterior wall =10, septum/post wall ratio =1.1, normal wall motion, EF =60%, RV =2.0, RA normal size, PA normal, AV excursion =1.9, AV peak velocity =1.7, MV E-F slope =150mm/sec, est. PA sys pressure =30-35, est. mean left atrial pressure =9-10, no pericardial effusion.  From 2001 to 2005, insufficiency has been mild on AV, and trace on MV, PV, and TV.  I have no symptoms and very good exercise capacity (I can get into the 7th level on the Bruce protocol).  Is there a concern with the pulmonary pressure in the context of everything else?  I have an routine physical scheduled in two days with the cardiologist.  Is there anything that I should ask?

[Cleveland Clinic]

Osiag,

Thanks for the post.

Looking at numbers form an echo is like looking at each of the pixels from a picture and gives an incomplete picture.  Without seing the echo its impossible to fully answer your question.

A lot of things can cause pulmonary hypertension such as lung disease, heart disease, and rheumatologic disease. The most common cause is generally systemic hypertension and its long standing effects on the heart.

Overall, there is nothing overly concerning with your described echo, especially if you do not have any symptoms.  I would make sure your blood pressure is under good control and keep routine followups with your physician.


good luck!

[steveki]

Sorry to hold this thread hostage, but I cannot seem to ever ask a question on it's own, the forum always tells me that the max. # of questions have been reached for the day.

I am a 32yr old  male of eastern european descent, I have exercised played sports and lifted weights all my life. Heart disease runs on my father's side, father is 55 and has had 2 heart attacks and bypass surgery, but never any rythmn problems at all. My mother has experienced light PVC's. At 19 I had my first PVC episodes and they came off and on but pretty mild up until about a year ago, I started getting them bad. Now, I get all sorts of arrythmias....last spring I went to a cardio on my own bill ( I'm a personal trainer on my own and pay my own medical) and after some pricey blood work, ekg, ecg, and stress test with the dye, my heart was fouind to be normal. I also wore a holter for 24 hrs and had pvcs, pacs, and atrial fib....doc offered some beta blockers which I turned down ( I took them before and they did nothing for me)

I can still function and exercise, but its getting harder. As of about a month ago when I lay down at night, I get a chronic PAC beat that pauses my heart altogether then restarts it...these are hard to feel if youre doing something else, but scary at night when you are laying down, I hear a sound when they happen deep in my ears that sounds like an electric current change and often my vision is comprimised for a brief second, but no shortness of breathe or anything like that.  These beats are the ones that also give me stabbing pains now and then. The PVCS I get during the day mostly and they range from hardly noticable to  almost incapacitating me and shaking my very soul.

I have tried everything...diet..calcium and mag. supplements..antioxidants....herbs....everything....the magnesium supps.  do supress the PVCs but do nothing for the PACs that fill my nights with terror.

This condition is ruining my life. My work, my mental state, my overall health (anxiety is killing me) is being overtaken by this. I feel broken and no one can fix me or even worse understand what is happening. I cannot keep running back to the cardiologist here in Pittsburgh to have more monitors strapped to me, I just can't afford doing that forever. Does anyone have any idea what I can do next? If I keep getting new rythmn disturbances, how long wil it be till I get the truly dangerous ones? Why wont it just beat normal? i try to be healthy, try to eat right and exercise, and this is my reward. They are destroying my life worse than anything I have experienced, they control my day and fill my nights with terror and anxiety.

Anyone with any input would be greatly appreciated. Thank you.

[fearfactor]

I know how you feel - PACs and PVCs have just about ruined my life too.  But I know deep down inside that they WILL NOT kill you if you have a normal heart.  Have you gotten a stress test, an echocardiogram, any other heart tests?  If not, see a cardiologist.  I did, and was told my heart is totally normal and healthy, but I still have these arrhythmias.  If you have a normal heart they won't kill you though some days they will make you wish you were dead (just kidding!).  I know how disconcerting, how worrying they are.  I know the advice to ignore them and go on with life rings so hollow when you're scared for your life.  But these PACs and PVCs will not degenerate into dangerous rhythms in the absence of some kind of heart disease or a condition like QT prolongation.  Get reassured that you don't have these conditions from your doctor and know there are SO, so many people who have the same thing and we are all alive and kicking.  Read the posts on this board - there are so many here who have the same thing you do and are just as anxious about it.  You aren't alone.  Hang in there and I hope you find some peace soon.

[fearfactor]

Sorry - I just reread your post and saw you have had all the tests.  That is good - your heart is normal and you can be reassured that you're not going to die from these arrhythmias.  I know that doesn't help much (I've been told the same by so many doctors, psychiatrists, etc. it isn't even funny anymore) but just try to remember that when you're afraid.

[3dognewt]

I too, tried for months to get a question and got the same message, but one day, I was lucky and got through. All I can say is keep trying at different times and one day you will get through. In the meantime keep reading all of the posts on this forum regarding PVCs (etc) because they are what kept me sane while I waited for an appointment with a cardiologist. There are many wonderful people here experiencing the same thing as you, myself included. I suffer from between 10,000 to 20,000 pvcs every 24 hours. this has been going on for almost 2 years. After all the battery of tests and a visit to a well respected cardio, who I trust completely, and after getting support from the many sufferers here, I have come to terms with the skips. As hard as it may be, you have to treat the anxiety first in order to deal with the benign arrythmias (unless you choose medication, which I didn't) I still get them, I still hate them, but I will NOT let them ruin my life. You are not alone, there's a lot of us sufferers out here.