Hi, I am a 48 yr old female.
Recent history of slight shortnes of breath, numbness/tingling in left arm on exertion and night palpatations. Also occasionally lightheadedness and elevated/thready HR during exercise.
Had ECG - normal
Echocardiograph results as follows
Exercise stress - pt exercised according to accelerated Bruce protocol.No chest pain. HR increased from 83 to 196bpm after 5min 43 sec. BP increased from 120/80 to 165/75. At peak of exertion there was widespread rather horizontal ST segment depression in leads II,III. aVF and V4 -6 between 1-2mm.
Resting echo - LV size was normal with good systolic func. All left vent. segments were normokinetic. There was mild aortic valve regurgitation and the right ventricular systolic pressure was elevated at 49mmHg. There was mild tricuspid valve regurfitation. Sinus rhythm, cor pulmonale (?right atrial strain)
Immediate post exercise echo - All left ventricular segments become hyperkinetic and the left ventricular ejection fraction markedly increased compared to baseline examination.
- good maximum workload achieved
- good heart rate and response to exertion
- Abnormal ECG consistent with pulmonary hypertension (RVSP 49mmHg), per pulmonale, cause (?)
- No evidence of myocardial ischaemia based on echo criteria
I am most concerned about the RVSP of 49 which seems unusually high. My GP does not think I need to bother with follow up, but the suggestion of pulmonary hypertension has me concerned.
Any ideas, suggestions?
Too much specific details/numbers for my knowledge base, but the overall sound is positive, as you GP seems to say.
Does the pulmonary hypertension mean you have elevated blood pressure? If so, I'd think some medication to lower your BP would be in order, and I'd suggest the same to my doctor is that were my situation.
I assume too you continue to have the symptoms in your opening paragraph. That being the case, I think you should tell your doctor you need help with some relief from these symptoms.
Thanks Jerry. I have app. in 8 weeks with cardiologist who should give me answers. I do not have high blood pressure. The pulonary hypertension is high blood pressure only in the heart/lung arteries. My regular Bp is just fine.
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