Tricuspid Regurgitation & Pulmonary Hypertension

[Jeanine__0]

Posted by Jeannine on May 29, 1999 at 11:20:09
Hello! Thank you for your time!
I had a echocardiogram done ,Dr. heard a murmur and a click.
Results are: Mild to moderate tricuspid regurgitation & mild pulmonary hypertension.No MVP. Anterior leaflet mildly elongated & slightly thickened.
No evidence of aortic or pulmonic regurg. Right ventricular pressure 38mmHG,assume central venous pressure of 10.Biventricular wall motion
normal est ejc fraction 61%.
Heart Rate 73                                       LV post wall-diastole 0.6
Aortic Root 2.6                                      LV diastolic dimension 4.0
AoV excursion 1.7                                 LV systolic dimension 2.7
L atrium 2.3                                           Fractional shortening  32   (>27%)
Septal wall thickness-diastole 0.6         Regurgitation:
Pericardial Effusion     No                     AoV     No       TV   Yes
RV Pressure   39 mmHG                      MV       No       PV   No
Height 69"  Weight 107
(have gastroparesis-ideopathic taking Domperidone)
Family history of heart attack,aunt had fatal heart attack at 49,found
enlarged heart & lungs 1/2 greater than normal size,she smoked.
Recently I have been tired and unable to do more than 15 min of
activity without exaustion. Blood work ok for anemia ect. could be due to gastroparesis.I do not smoke.
My questions are:
Can the leaflet mentioned cause the pulmonary hypertension,also can it cause the regurge?
Ive read about pulmonay hypertension being progressive/fatal.
Since this is secondary pulm. hypert. does it take the same course?
Can mild pulm. hypert. be corrected if the primary cause is a valve regurg?
What figure above represents pulmonary blood pressure?
Is this something that would warrant additional investigation and if so
what additional tests would be good to confirm the findings?
Is this something that can worsen with time or is this common?
Sorry so long! I will be seeing a cardiologist next week .
Thank you again for your time,any info would be greatly appreciated.
Jeannine

Posted by CCF CARDIO MD-APS on May 31, 1999 at 10:40:09
Dear Jeannine,
Pulmonary hypertension is potentially reversible (especially when caught in the mild to moderate level) when the cause is repairable (i.e. it is secondary to a fixable cause.)  You are right in saying that primary pulmonary hypertension is a bad disease in that it is usually progressive and not very treatable.
I believe you are a little confused as to how regurgitation and pulmonary hypertension are related, and your best bet is to have the echo with you when you see the cardiologist so that s/he can go over the results and subsequent prognosis with you once s/he had done a full history and physical exam (and thought about your case.)  Mind you that a small amount of tricuspid regurgitation is normal on echo and the only way to truly measure the pressures in the right side of your heart is to put a catheter in your right heart (a procedure called a right heart catheterization.) There is no number on the echo results that represents the actual pulmonary arterial pressure, rather it is inferred by interogating the triscuspid regurgitation.
I think your echo warrants further investigation if not a follow up echocardiogram and regularly scheduled physical exams with the cardiologist.
I hope this information is useful. Information provided in the heart forum is for
general purposes only.  Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.