PH?

[Me1420]

I recently had an echo done with an RVSP of 36 mmHg.  I'm a single mom and scared to death that I could have PH. I went in for heart palpitations and dizziness. So the RSVP was an incidental finding.  The ENT thinks the dizziness is due to peripheral vertigo. The cardiologist just said that he wanted me to come back in 1 year for another echo. He did not want to do a catheterization. I'm 33 years old, 5'7" and about 160 pounds. Up until a few weeks ago, I worked out 2-3 times a week, went on bike rides, etc. with no difficulty. The fear is paralyzing. A year is a very long time to wait when I think about the life expectancy and stress of waiting and not knowing.  

1.  Should I insist on further testing for PH?
2.  Are there other factors that point to or from a diagnosis of PH?
3. Does this indicate PH?
4.  Are there any specialists in my area (northern Indiana)? I'm willing to travel though.
5. How long are people living with PH? With an RVSP of 36?

Here are the rest of the echo results:
Aortic root 3.1 cm
Left atrium 2.8 cm
Right ventricle 2.0 cm
Interventricular septum 0.8 cm
Posterior wall 0.7 cm
Left ventricle in systole 2.6 cm
Left ventricle in diastole 3.9
Left ventricular ejection fraction estimated to be 70%

The aortic valve was trileaflet with normal peak aortic systolic velocities. V-max was 1.5 m/s, peak gradient of 8.9 mmHg, mean gradient of 5 mmHg, no aortic insufficiency.

Minimal mitral valve prolapse involving the anterior leaflet of the mitral valve with trace of mitral insufficiency.  No evidence of mitral stenosis. V-max was 1.0 m/s, peak gradient of 4 mmHg, mean gradient of 2mmHg, P 1/2 T 82 ms.
Mild tricuspid insufficiency with mild pulmonary hypertension and right ventricular systolic pressure of 36mmHg.  Overall well preserved left ventricular systolic function with left ventricular ejection estimated to be 70%. No evidence of segmental wall motion abnormalities.

Everything else appeared normal.  

[Jonathan D. Rich, MD]

Hello and welcome to the forum.

My sincere apologies for this relatively late reply.  I had been out of the country traveling.

1. Take a deep breath and know that I feel VERY confident that you do NOT have pulmonary hypertension.  I of course can not tell you this for sure in a forum like this but PH is very unlikely (to be clear, I am loosely using the term PH to mean any sort of PH that you have anything to worry about).  Please ignore the RVSP of 36.  Seriously, ignore it.
2. Are you still having symptoms?
3. If you are feeling better and are relieved to know that you likely do not have PH, then great.  However, I do sympathize with what you are going through, particularly the fears.  If you are interested and willing, I would be more than happy to see you in the office for an evaluation.  I am in Chicago and not too far from you.

Wishing you all the best and enjoy being a mom!

Dr. Rich

[Me1420]

Thank you for this forum. I'm sure you're very busy so I appreciate you taking the time to do this. I don't mean to be pushy but I'm terrified. Could you please give me some guidance?

[sudsy120]

I would definitely follow up with a PH specialist, you can find a list on the pulmonary hypertension association website.  PLEASE don't read things on the internet, get all of your info off the PHA website, it is the gold standard.  PH is soooo scary, I know.  I was diagnosed just under a year ago after a right heart cath, led up to by dizziness, shortness of breath, and multiple incidents of passing out.  I am also young, 33 years old with 4 young children so I know how terrified you are feeling.  Please follow up, the only true diagnostic test for PH is a right heart cath.  Good luck