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Possible PFO right/left shunt borderline pulmonary hypertension

I presented at hospital one year ago with possible TIA.  All neurological tests were negative.  Echo with saline was performed.  Here is the catch :-)  Cardiologist that I followed up with NEVER got a copy of my echo.  Whole other issue.  Now....fast forward one year my internist catches this and freaks out and calls the cardiologist.....going in Monday.
Echo showed right to left shunt. (origin unknown) but suggests trans pulmonary transit
Borderline pulmonary hypertension
Right ventricular cavity borderline enlarged.
Naturally I am freaking out that this was diagnosed a YEAR ago with no follow up.  I was told I was fine.

Is this really bad?

45 year old healthy (or so I thought) female.
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367994 tn?1304953593
I am posting the answer to the same question on your other post. by kenkeith , 6 hours ago
To: gray46Q: Echo results were right to left shunt seen by agitated saline suggesting trans pulmonary transit.
Right ventricular cavity borderline enlarged
Right ventricular systolic pressure estimated to be 30-40 mm.
Right ventricular function is normal".

>>>>>I can provide some insight into what the report describes, and you won't have a fatal event in the short term.

Usually, with PFO there is a shunt from the left to right chamber because the left side normally has the highest intr-chamber pressure.  Going from the left to right lower chamber mixes good oxygenated blood with the blood that is going to be pumped to the lungs to be oxygenated, and there is very little medical significance,

But when the left ventricle's oxygenated blood is mixed with the right chambers "dirty" blood reduces the oxygenated value of the blood circulated into the system.  The underly cause can be the higher than normal pulmonary artery pressure with increase the right ventricle's pressure and enlarge the chamber size.  Then this increased pressure can/will shunt some blood to the left side.

An estimated pulmonary artery systolic pressure greater than or equal to 40 mm Hg by echocardiography is considered significant pulmonary hypertension, and that could indicate the high pressure is due to the resistence from  blood clots (emboli) in the lungs, or pulmonary artery thombrosis (clot) of that vessel.

A TEE provides a different view of the interested location that the chest echo cannot properly image.  According to the echo the right chamber is slightly dilated, pumping normally, and there is some resistance that the right ventricle pumps against.

Hope this helps, and if you have any further questions or comments you are invited to respond.  Take care, and I wish you well going forward.

Ken

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