borderline high cardiac output

[jan]

Dear Dr.,

I had a right heart cath to rule out PH, because it was on my last 2 echos.  I got the actual report and thought the "recommendation" was a mistake, because I do not have PH, thankfully.  Then as I read over it again I thought maybe it wasn't due to the "summary" and "hemodynamics" remark (they are the same):

"Hemodynamic assessment demonstrates borderline high cardiac output and normal pulmonary capillary wedge pressure."

The recommendation, "Patient management should include aggressive medical therapy."

I have a page + of numbers, but didn't know which ones to put here.  I think I remember the pulmonologist pointing to "pulmonary flow" @ 6.43

Is borderline high cardiac output something that needs treatment?  (I will be taking the report to my cardio next month, my reg. 6 mos check up).

I have Lyme, IST, NCS, mild mvp, mr, and tr.  Raynaud's, colitis, well a host of other things due to the Lyme. I am 50, 117lbs. @ 5'5".

Thanks for your help,
jan

[CCF-M.D.-PPB]

I am not sure what they meant by aggressive medical therapy.  Often times physicians write that to indicate that there is no need for any further interventions.  Since you have no particular symptoms and you don't have pulmonary hypertension there really isn't that much to treat.  The high cardiac output may mean multiple things.  False positive results is the most likely etiology, followed by conditions such as anemia, thyroid problems, all the way to more serious things such as ventricular septal defects, paget's disease, AV malformations etc.  I wouldn't worry about those too much since you don't have any symptoms.

[jan]

OK, I know the dr. doesn't usually respond to add'l comments, but  I can't figure out if I am confused by his response or I didn't post my question clearly.

I thought the recommendation may be for the borderline high cardiac output, not the non-existent PH. So, I wanted to know if there is a treatment for the cardiac output.

I have lots of symptoms, but wouldn't know what type of symptoms you are looking at for cardiac output.  I am not well, I haven't felt well for years.  I'll tell you symptoms that have me puzzled... SOB w/o the tachy occurring, light-headedness just "walking" on my treadmill for 35 mins., often dizzy, lots of palps from various short runs of arrhythmias other than the tachy.,  fatigue.
Like I said though, I have Lyme (chronic) and it has caused me plenty of symptoms and multiple diagnoses.

[maggiemag]

The doctor's response was that the high cardiac output result may really be a false positive, in other words, he thinks you may not even have high cardiac output.  And if you do, then it may be due to anemia, thyroid issues or other things, that would need further investigation to determine which and thus determine the treatment.  Hope this helps!