Mitral Valve Regurgitation and PH

[Missypauline]

I have Mitral Valve disease and my cardiologist has told me that this leaky valve has caused me to have Pulmonary Hypertension. I see my cardiologist every three months to discuss if it is time to have the valve replace (open heart surgery). I have known about the PH for ten months and only recently found out my valve problem was somewhere between moderate to severe. I have asked for a right heart cath and been told that the blood pressure in my lungs and in my heart is elevated but that an echo every three months was all I needed. I am on cardiac meds but no medications for the PH. How serious is this condition and why can't I get a right heart cath? Does that matter? Or are echoes sufficient?

[Missypauline]

I have just discovered this forum and I am so glad that I did! Thank you for your response. I appreciate it very much!

[Jonathan D. Rich, MD]

Hello and welcome to the forum.

1. Mitral regurgitation is a common cause of "PH", elevated pressures in your lungs.  The PH is directly due to the mitral regurgitation and it will resolve once the regurgitation goes away (ie after a valve replacement).
2. Because of this, you do not need treatment of your PH per se but careful decision about timing of mitral valve replacement between you and your doctor is very important.  There are several criteria by which to decide when its time to fix the problem.  The presence of significant PH is one of the "softer" indications.  I think a RHC at some point would be reasonable.
3. I am glad that your doctor is getting frequent echos and following you closely as I suspect he/she knows the criteria for valve replacement and is following you closely.

All the best,

Dr. Rich