Pulmonary Hypertension

[RJ538]

Hi , I am 43 years old, about 6' 2" and 215 pounds.  Since I was a teenager, I have been a overweight (on average about 30 - 40 pounds) and never smoked. When I was 9 years old, I went to the doctor and he listened to my heart.  He heard a murmur so he put me in the hospital.  They think that I had Rheumatic Fever. They told me that the murmur would probably go away someday. Since 1993 I have had several echocardiograms.  Here is the summary of the things that they found wrong:
1993 - The anterior leaflet of the mitral valve is minimally thickened.  There is a mild prolapse of the anterior leaflet of the mitral valve.  There is a presence of trace pulmonary insufficiency.
2001 - LV Thickness is at upper limits of normal (5.9 cm).  Mildly Dilated Aortic Root.  MV and AV leaflets open normally.  Doppler shows: +1 PI , +1 MR, +1 TR
2003 - 1+ Mitral Reguritation; LV abnormal at 6.0 cm
2005 - Trace pulmonic insufficiency; Trace to 1+ mitral regurgitation
2006 - Trace mitral regurgitation and pulmonic regurgitation
2008 - Mild mitral regurgitation is present 1+. Mild tricuspid regurgitation present.  The right ventricular systolic pressure (RVSP) is 40+RA. There is mild pulmonic regurgitation noted.  Also, my EF is 58%, TR Vmax is 2.72 m/s and TR maxPG is 30.93 mmHg.
Other history - my LVIDd size from my first echo to the last one has been measured at 5.8, 5.9, 6.0, 5.4, 5.6, 5.7 cm.  Since I was a kid I always seemed to get out of breath faster than other people at my age.  I could run fast for short distances but I always had a problem running longer distances.  I also sweat very easily.  My blood pressure has always been normal but it was 140/100 on the day that I met with my cadiologist.  My cardiologist was a little concerned about the RVSP of 40.  He said that he didn't think that I had Pulmonary Hypertension, that my Electrocardiogram was normal and then he sent me to a pulmonary doctor.  The pulmonary doctor did a chest X-ray which was normal and a lung capacity breathing test which I passed.  He wants me to get a Swan-Ganz catheter test to get a more accurate reading of the pressure in my heart/artery.  This really scared me since I have read that a potential complication is a heart attack or stroke from this invasive procedure.  I asked him if they could do a CAT scan or a blood test instead but he said that instead of sending me for all of these other tests it would be best to start with the catheter.  I am very afraid to get this test.  He also said that I could wait 2 months and have another echo.  I am very afraid that I may have Pulmonary Hypension since I have read studies where Tricuspid Regurgitation is tied to Pulmonary Hypertension.  My 2001 echo showed a +1 TR (which I am guessing is Tricuspid Regurgitation) but there was no other mention of it on that report or any reports since then up until now.  Here are my questions:

1.  I walked about 4 blocks and then waited 15 minutes before they started the echo. I wasn't out of breath.  Also, I was a little nervous during the echo (I get very nervous with anything that has to do with my heart based on my history). Could any of this have affected the RSVP reading?
2.  I was told that RVSP can vary from day to day, and that the expertise of the echo technician and doctor reading it can affect this number.  Is it possible that this could have raised the pressure up to 40?  (I was told that 30 or 35 was more closer to normal).
3.  I am afraid that by waiting to get another echo that I may be damaging my heart if I have Pulmonary Hypertension.  Is it okay if I wait another month or even another 6 months to get another echo?
4.  If I have Pulmonary Hypertension does oral medicine usually help?  How long can you usually live with it?
5.  I don't seem to have any of the other symptoms of Pulmonary Hypertension but I do get out of breath a little when I do things like strenuous yard work for example (but I have always gotten out of breath easily).  Then it takes me about 5 - 10 minutes before before my heart rate goes back to normal.  Does it sound like I may have Pulmonary Hypertension?
6.  Would a CAT scan or blood test rule out Pulmonary Hypertension?
7.  Could my borderline high LVIDs or mitral valve problem have caused Pulmonary Hypertension?  Even if I don't have Pulmonary Hypertension, could the high LVIDd number eventually lead to heart failure?
8.  None of my echos shows the size of my Right Ventricle.  Wouldn't I need to see if it increases in size to diagnose Pulmonary Hypertension?
I am extremely nervous and I am hoping that I can get some information that can ease my mind a little.  Thank you so much for all of your time.