Pulmanary Hypertension

[teetee65]

I am a 42 year old female with lupus, CHF, inappropiate sinus tach., cardiomyopathy,  uncontrolled hypertension,. EF 40%. I recently had a right and left heart cath. results are : PAP- 45/25 RV- 50/15 PCWP- 17 RA q:15 / v:13 AO: 160/90 LV: 160/20 C.O.: 7.93 CI: 4.35.  sats Ao: 91.9% pul sat: 74.1%.  What does all of this mean?  I am very SOB, fatigued with chest pain.  I am on coreg, sotolal, hyzaar... etc.
Any help would be appricated.

[Cleveland Clinic]

This now makes a little bit more sense.  Unfortunately, African Americans are more likely to develop HTN at an early age.  This is probably partially related to high salt intake in this country.  Try to limit it as much as possible.  Diuretics and CCB such as amlodipine are more effective in treating high blood pressure in African Americans.  The CCB will also lower the blood pressure in the lungs (PHTN) as well.  I would discuss this with you doctor.  There are some side-effects to CCB, most commonly lower extremity swelling, but being on Hyzaar may help with that.  Again, as I stated earlier, it is most important that you control your systemic blood pressure.  I think this is the root of the problem and when you fix it everything else will get better.    

[teetee65]

My Dr did a 24 hour Catecholamines test which was negative, also during the cath checked for renal stenosis.  My father is the only other person in the family that suffers from HTN but his is very controlled. I am aslo having a resting heart rate of 120.  I have has 2 ablations.  I am african american.

[maggiemag]

Since your PCWP is over 15, it is likely that the slightly elevated pulmonary pressures are due to a left heart problem.  It's kinda like back up pressure in the lungs and once you control the left heart problem, the PH will go away.  You might also have diastolic dysfunction which is a stiff left ventricle usually due to high blood pressure.  Even though you have lupus which makes secondary PH possible from the lupus alone, I would bet that it is due to the left heart.  Your cardiac output and index are excellent.  Hope this helps some!

[Cleveland Clinic]

Some people do have isolated pulmonary HTN without systemic HTN.  At this point it seems that you have both and it is possible that once you treat the systemic HTN you might control your pulmonary HTN better.  You pulmonary htn is only mild to moderate in severity.  You are only 42 years old and I am wondering why you developed HTN this early.  Has your physician looked for the less common causes of HTN in you yet.  What is your nationality, and have others in your family also had high blood pressure at an early age?

[teetee65]

So do I have to worry about the pulmunary pressures my EP seems to be cocrned about it, I am also on lasix.

[Cleveland Clinic]

Your heart is in pretty good shape.  The smalls problems that i am noticing is the elevated systemic blood pressure, hypertension which must be controlled and the fact that your arterial saturation is only 91.9% which may have to do with your lungs, not your heart.  The shortness of breath and the chest pain may be related to elevated blood pressure and the low oxygen saturation.