echocardigram

I am 55 had an echo cardiogram last october systolic pressure was 32 which they said is ok norm was under 30 so slightly off. Test also showed tricuspid valve had moderate leaking. Ok was under alot of stress this year feeling all sorts of systems chest pain, dizzness and lightheaded some shortness of breathe occasional papitations. So a doctor sent me in July for another echo cardiogram. This time it showed moderate valve leaking on the mitral valve and mild on tricuspid value and systolic pressue of 49. Both tests way off and done within 9 months. I asked cardilogist to retake test. He said could not for 6 months. He would do a right heart catherization. I do not know what to do. I feel this is alittle drastic and the both caridgrams are off. I have done a ct scan of chest with dye came out normal. And breathing tests at pulmonologist which came out normal. Lungs seem to be ok yet caridiogram showing pulmonary hypertension on the most recent one. what should i do please help

[CCF HeartMD6]

The results of an echocardiogram can often times have a wide variation across the recorded numbers due to a number of factors including (but not limited to) the experience of the operator, body positioning, and the experience of the interpreter.  However, if there is evidence of regurgitation of the tricuspid valve and concern for pulmonary hypertension (as evidenced by a high RV systolic pressure), the underlying cause should be identified as there are a number of different reasons that can cause this -- with different treatment strategies.  A chest CT would help identify if there is any evidence of a pulmonary embolus (if done with contrast and with the correct protocol) as well as any disorders of the lung tissue, but may not be too helpful in looking at the cause of tricuspid regurgitation. A right heart catheterization would be able to measure pressures in the different chambers of the heart which can provide useful hemodynamic information.  Unfortunately, it is impossible to be able to make an accurate diagnosis over the internet -- and without the ability to perform a complete history and physical as well as looking over the primary data.  If you have questions regarding the indications for doing any procedures, you should discuss this thoroughly with your cardiologist.