Results of echocardiogram

[Tim]

My wife had an echo. done recently which showed mild pulmonary hypertension, also mitral valve, and tricuspid regurg.  She also has chronic atrial fibrillation.  She is 31 yrs.  In looking back at an echo a year ago it was also noted that her pulmonary artery pressures were elevated, between 40and 50 mmHg.  In reading about pulmonary hypertension we are very concerned.  We are wondering perhaps why her cardiologist has not addressed this issue, or is it insignificant.  Much of what I have read   states one should see a PH specialist to determine a diagnosis.  Is it possible that the heart problems are caused by pulmonary hypertension or vice versa.  Or are the numbers too low to be concerned about.

Questions are:
A)Do you think she should have further testing to determine the cause and or make a diagnosis of ph, i.e.(right-sided cardiac cath)?

B)Is it possible that this of no concern, and that is why the Dr. has not addressed this issue?

C)If you think it should be investigated, should she see a PH specialist?

D)Is her heart arrythmias potentially causing the pressure increase or vice versa?

E)Do you have any additional thoughts or information about PH, or what might be going on?

Thankyou so much.  No matter what getting some sort of information will surely ease our minds.

[Cleveland Clinic, MD]

Pulmonary pressures are the blood pressures inside the lungs and may be elevated for a variety of reasons.  Valvular abnormalities are one reason.  Arrhythmias don't usually elevate pulmonary pressures.   If no reason can be found the elevated pressure is refered to as primary pulmonary hypertension.  Pulmonary pressures can be estimated based on echocardiographic findings but a right heart cath is still the gold standard.  A pulmonary pressure of 50 is on the higher side and probably should be evaluated further by a pulmonologist with experience in dealing with pulmonary hypertension.