Secondary pulmonary hypertension

Thank you for this forum and your expertise! I have a question about secondary pulmonary hypertension:
What is the most accurate criteria for determining if a person has SPH: Resting arterial pressure like in echoes, or measurement during activity such as in a stress test? I was told I have mild pul. hyperten. on echo but on stress test it shoots way up...which is more accurate in determinating this condition and deciding on if a patient needs medication (if symptomatic)?
Thank you! (also have corrected TOF, PDA and arrhythmias).
Also - I was told long ago that SPH is rare in a patient with TOF....true?
Thanks again!
Mrsally

[CCF-M.D.-CRC]

Dear mrsally,

Usually persons with tetrology of Fallot (TOF) have pulmonary valve stenosis (narrowing) and therefore the lungs are "protected" and pulmonary hypertension (PH) less common.  That being said if the pulmonary valve stenosis is mild and the elevated pressures long-standing PH could develop.  I don't really know that much about measuring pulmonary pressures during exercise.  I think most decisions are made based on the resting levels.  A pulmonologist may be able to give you a better answer.