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Pulmonary Hypertension on Echo
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Pulmonary Hypertension on Echo

Hello:

I am a 41-year-old female. Overweight, but otherwise previously believe to be in good health.
Recently went to Internist for extreme fatigue, sleepiness and epigastric abdominal pain.
All abdominal tests came back normal, but in the course of my visits I was diagnosed with Hypertension and given EKG and Echocardiogram.  

Today the doctor gave me the results and said I have Pulmonary hypertension.  He will be referring me for a CT angiogram.  This blew me away because I have been complaining of shortness of breath to my previous doctor for a couple of years now.  The last time I saw her I told her that it was really starting to concern me.  She said it was because I am overweight.  I told her no, that I thought it was more than that.  I told her that I was trying to exercise, but I cannot hardly walk a block without getting short of breath.  She did an EKG and said I was fine.  Although this concern was one of the reasons I decided to try a new doctor I was not expecting anything with heart/lungs, and I was so surprised I did not ask all the questions I should have, and I am not sure how concerning this finding is.

I am pasting my Report below.  I know specific answers are not possible, but in general what do you see in this report:

Indication
Other: HTN, arrythmia
Interpretation
Ejection Fraction: 61.00
Impaired Relaxation: Yes
Ventricular Dysfunction: Diastolic
Cardiomegaly: No
Hypertrophy: No
Dilation: Yes
Location: Atrial
Valvular Abnormalities
Aortic
Stenosis
Insufficiency/Regurgitation
Severity: MildModerate
Mitral
Normal
Insufficiency/Regurgitation
Severity: Moderate
Tricuspid
Normal
Insufficiency/Regurgitation
Pulmonic
Normal
Insufficiency/Regurgitation
Severity: Mild
Pericardial Effusion
No
Pulmonary Artery Pressure: 48
Comments: Mild AS  ava 1.83cm2   peak gradient 3mHg


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242508_tn?1287427246
This report is difficult to decifer, however, it appears that you have mild aortic stenosis and moderate pulmonary htn.  Aortic stenosis in someone who is 41 years old is usually associated with a bicuspid aortic valve, however, because this is mild it is not the casue of your pulmonary HTN.  The valve needs to be evaluated on a yearly basis with examination, and echocardiography every couple of years.  The pulmonary HTN is moderate and if accurately measured unlikely to cause your shortness of breath at rest.  I cant say the same about exertion, as it is likely that exercise increases your pressures even higher.  Unfortunately, the problem with echocardiography in evaluating pulmonary pressures is that it tends to be inaccurate frequently.  Obesity can sometimes be associated with sleep apnea which can lead to pulmonary HTN.  Weight loss and exercise as well as wearing nocturnal CPAP usually help.  If you are having lots of shortness of breath I would recommend that you see a cardiologist who may ultimately end up getting a right heart catheterization to figure out what is going on with the valve and the pulmonary pressures.  
4 Comments
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Avatar_n_tn
I am not a doctor, but  you do have impaired ventricular relaxation, which is also called diastolic dysfunction.  This means that the ventricle is stiffer than normal and does not fill normally.  This condition is associated with elevated pulmonary pressures as well.  It is NOT the same as PPH which is rare.  This type would be due to a left heart problem, the diastolic dysfunction, and is more often associated with high blood pressure.  The treatment would be to lower the BP, which in turn may lower the pulmonary pressure.  That said, the only way  to know for sure is a right heart cath, plus a left heart cath in your case.  Echoes can be waaaaaay off.  I would seek out a PH specialist, not a cardiologist.  I don't know about the aortic problem, but I hope this helps some.
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Avatar_n_tn
It was just discovered that I have "atrial septum defect" producing much the same systems.  From what I understand it is a hole between the right and left side of the heart, it is supposed to close after birth.  Previous to birth it provides blood to the heart from the mother to the fetus's heart.  Mine never closed.  
A "bubble test" confirmed the diagnosis.  I am 53 yrs old and hoping that years of my heart working incorrectly have not done too much damage.  It causes pulmonary hypertension and even heart failure.  Much depends on the size of the hole.
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Avatar_n_tn
Were they ever able to hear a split S2 indicating an ASD earlier in your life?   It's just interesting because these dont just happen all the sudden.  S2 (second heart sound) will split (sometime wide) the pulmonary/aortic components.  Unless I'm wrong, I thought this was the case with all ASD's.
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