RVSP 42.5 mmHg

I am a 64yo female with 10 year  history of hypertension.  I had a pacemaker put in 5 years ago after diagnosis of SSS.  My latest echocardiogram in 12/2012 showed RVSP of 42.5 mmHg, EF of 65%, mild regurgitation of mitral valve, mild to moderate regurgitation of Tricuspid valve, a trivial pericardial effusion was identified posterior to the heart with no evidence of hemodynamic compromise.  The left and right ventricles were normal.  The right atrium was mildly dilated.  RAP was 10 mmHg and TR Vmax was 2.9 m/sl.   I don't know if my cardiologist has seen the results.  I haven't seen her for 2 years since I was seeing the VA doctor and was doing fine, but after finding BP 180 to 225 systolic for 5 weeks and having adjustments  to meds by VA doctor,  I called the cardiologist's office while my VA doctor was on vacation and  the PA in the cardiologists office saw me.  She said I needed an echocardiogram and renal ultrasound done so my VA doctor ordered it since they cover it for me.   I don't have an appointment with my cardiologist  for another 8 weeks.  Would these results warrant some concern?  Should I just wait for my scheduled appointment or try to get it moved forward?  I feel good, have lost 40 pounds in the past year so am now normal weight, and walk 11/2 mile most every day.  My last echo was at least 6 years ago but  I don't have the findings to compare them with this one.  I have been doing reading about PAH and wonder if this is possible.   I have more values on this summary but don't know which could be helpful for you to know.  I would appreciate an answer.  I don't want to worry about anything if there is no reason to, but also feel like with using two different doctors, possibly something is getting overlooked.    Thank you for any help.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

For RVSP the normal value is less than 35 mmHg. A reading above 40 mmHg would be considered mild pulmonary hypertension. A renal disease can cause an elevated systolic pressures. A right heart catheterization can give a more  accurate picture of the heart pressures and which medical regimen would best benefit the patient. But as you do not have symptoms of breathlessness or chest pain and since your ejection fractions is good, you doctor may decide to wait before proceeding to more invasive investigations.

Hope this helped and do keep us posted.