Tests for Pulmonary Hypertension

I was recently diagnosed with SVT and now an echocardiogram shows right side enlargement.  My specialist suspects pulmonary hypertension and has so far given me a VQ scan which has proved negative.  I am due for a TOE which I think is an oesophagal tube which can give an echocardiogram of the heart from the back and cross section.  I am also due to wear a Novacor monitor (when our NHS can get one!).  Will these tests determine once and for all whether I do also have PH?  I do understand the implications of primary and secondary, as my mother died of sudden heart failure in her mid-fifties, although the exact cause was never diagnosed.

[kenkeith]

I believe the test scheduled is a TEE. Transesophageal echocardiogram. If it's difficult to get a clear picture of your heart and lungs with a standard echocardiogram, your doctor may recommend a transesophageal echocardiogram

A better test to evaluate includes a right heart cardiac catheterization and bypass TEE. I have provided information from the Mayo Clinic regarding diagnosis of pulmonary hypertension.

■Right heart catheterization. After you've had an echocardiogram, if your doctor thinks you have pulmonary hypertension, you'll likely have a right heart catheterization. This test is often the most reliable way of diagnosing pulmonary hypertension. During the procedure, a cardiologist places a thin, flexible tube (catheter) into a vein in your neck or groin. The catheter is then threaded into your right ventricle and pulmonary artery. Right heart catheterization allows your doctor to directly measure the pressure in the main pulmonary arteries and right ventricle. It's also used to see what effect different medications may have on your pulmonary hypertension.

Right heart catheterization is usually performed under local anesthesia and sedation in a hospital setting, but you often can go home soon after the procedure. You'll need someone to drive you home after the test.

Your doctor may order additional tests to check the condition of your lungs and pulmonary arteries, including:

■Pulmonary function test. This noninvasive test measures how much air your lungs can hold, and the airflow in and out of your lungs. During the test, you'll blow into a simple instrument called a spirometer.
■Perfusion lung scan. This test uses small amounts of radioactive substances (radioisotopes) to study blood flow (perfusion) in your lungs. The radioisotopes are injected into a vein in your arm. Immediately afterward, a special camera (gamma camera) takes pictures of blood flow in your lungs' blood vessels. A lung scan is then used to determine whether blood clots are causing symptoms of pulmonary hypertension.

A perfusion lung scan is usually performed with another test, known as a ventilation scan. In this test, you inhale a small amount of radioactive substance while a gamma camera records the movement of air into your lungs. The two-test combination is known as a ventilation-perfusion (V/Q) scan.

Hope this helps give you a perspective so you can have a meaningful consultation with your health care provider.  Thanks for sharing and you are welcome to post any follow up questions.

[JoKelly]

Many thanks for your most helpful reply.  I have had the lung perfusion and ventilation (called VQ  here I think) scans and these are negative.  The TEE test will be soon.  He has not so far mentioned the right heart catheterisation, so I will be prepared for that.  The monitor has a waiting list!
Jo

[kenkeith]

Thanks for your reply, and I wish you the best.