confused on data

[cmick101]

I had originally posted a question and your response was for me to obtain the actual data and submit it.  I did so a few days ago but haven't had a response.  

If you would be so kind as to review the data I received from the actual RH cath report I would greatly appreciate it.  Any thoughts/interpretations would be very helpful as it is a long time till I can see the doc again for review.

The values are at rest/with exercise

Cardiac output  12.7/16.2
mean RA 12/19
systolic RV 37/44
diastolic RV 13/19
systolic PA 32/45
diastolic PA 16/28
mean PA 20/34
PCW 14/28
PVRI 87
LVSWI 95.1
CI 5.52
PVR (wood units) 0.47
SVRI 1405
RVSWI 8.0
SI 73.6
RA sat% 84.4
PA sat% 82.7/88.9
Arterial O2 sat% 98.0/99
LPA sat% 83.3

The doc gives the following impressions and indications

Secondary Pulmonary Hypertension
Non Systolic Heart Failure
High Output Heart Failure
Possible L-R Shunt
Elevated RH filling pressure with elevated LH filling pressure
Results consistent with Hyperdynamic State

Thanks very much

[cmick101]

Thanks very much for the input.  When they were doing the RH cath the 2 docs were discussing the likelihood of a L-R shunt causing the problem.  The whole thing started some months ago, first with a noticeable level of general fatigue (which has gotten worse over time) then a serious SOB problem.  I ended up being hospitalized for 4 days cause they couldn't figure out why the nitro helped.  That doc sent me home with an rx of anxiety and told me to take antidepressants.  Sooo... I went to Johns Hopkins where the did the RH cath with the above results.  The med keeps getting increased slightly (Diltiazem, now at 360mg/day) and it does help.  My family does have a strong history of high BP but so far I haven't had any real problems with that.  I have routine doc visits about every 3 months (due to epilepsy) and the BP is always 120 - 130/70 - 80.  Wifey is a nurse and insists on taking my BP often - so far it's been good.  I do appreciate the comments on the numbers not being high.  I hope your experience isn't first hand, or if it is I hope it is at least under control - I do wish you good health.  It's still a bit till I can get in to see the JH doc for a review, but your explanation does put my mind at ease a bit.
Thanks very much and best of luck to you.

[maggiemag]

I am not a doctor but I am familiar with some of the terms.  It appears that you do have an exercised induced mild pulmonary hypertension, but that it is not primary PH (PPH).  Your pulmonary vascular resistance is not up.  Your pulmonary wedge pressure is elevated and even more so with exercise, suggesting a left heart problem causing the PH.  It appears that the left heart problem is a diastolic problem, and not a systolic, with the elevated filling pressures.  This might be called diastolic dysfunction, which is common as we age, and also after history of hypertension.  You aren't that old ;-), so I bet you have a history of high BP.  The treatment is for the diastolic dysfunction, mainly keeping the BP low.  Sometimes patients are given Revatio and that helps.  Traditional meds for PH are not appropriate.  Your cardiac output is not low, so that is good, but they mention high output failure, which may be true.  This can occur with severe anemia, but I tell ya.........my last right heart cath had a similar high cardiac output and no one paid any attention at all.  Your oxygen sat is normal at rest and with exercise so that is great!
I hope this helps some, but certainly ask  your doctor any questions and what their plan is for treatment.  From my viewpoint it doesn't look serious.

[ireneo]

I personally can't comment because I have no idea what all the numbers represent or what the values should be. The main part is under the doctor's impressions. It mentions heart failure but no idea how severe. The left to right shunt is only a possibility. There's some hypertension which you probably have seen when your blood pressure was taken but again, no idea how bad it might be. Perhaps someone else will come along and understand all these test results. Have you tried posting on the doctor's forum? It's hard to get a question in since they only take 2 a day.