Pulmonary Hypertension Expert Forum
Possible Pulmonary Hypertension
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Pulmonary hypertension is a condition associated with high blood pressure in the arteries that connect your heart with your lungs. It is a serious condition for which there are many emerging treatments but no definite cure. In this disease, the blood vessels that carry oxygen-poor blood from your heart to your lungs become hard and narrow, which causes your heart to work harder to pump the blood. This forum is a place to ask questions about Pulmonary Hypertension. Some examples are: What caused me to get pulmonary hypertension? How is pulmonary hypertension diagnosed? What treatment options are available?

IMPORTANT!! If you have a question that requires immediate medical attention, or if you think you may have an emergency situation, please call your doctor or 911 IMMEDIATELY!

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Possible Pulmonary Hypertension

I developed shortness of breath mid-November.  My doctor heard a heart murmur during a routine check up, ordered an echo and found a moderate to severe tricuspid regurgitation, a slightly enlarged right ventricle, a mildly enlarged right atrium, right ventricular systolic pressure of 46, no signs of left side heart problems.  No blood clots in lungs.  No autoimmune disease.  No lung disease.  No hx of phen-fen. I do have a Medtronic Enpulse pacemaker since 2005 for a diagnosis of sick sinus.  This is my 3rd pacemaker.  I also have had a RNY gastric bypass and a partial pancreatectomy for nesidioblastosis which developed after the gbs.  
I am scared I have developed pulmonary hypertension.  What are the chances that I have PH?
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1884349_tn?1353818598
Hello and welcome to the forum.

It is possible that you have pulmonary hypertension (PH) but I can not emphasize enough that not all PH is created equally.  Many people have forms of PH from certain causes and the PH itself is not the problem (but rather an innocent byproduct).   It is also quite possible that you do not have PH at all but rather have the "tricuspid regurgitation", etc as a result of having a pacemaker in for several years (this can sometimes happen because the pacemaker leads travel across the valve and can sometimes lead to leakiness).

If you are comfortable with your current cardiologist then I suggest that you continue to undergo an evaluation with him/her to reach a final diagnosis (and create a treatment plan). Otherwise, I suggest you see either a different cardiologist (possibly a heart failure specialist) or a PH specialist.  I would be happy to see you if you are near the chicagoland area (or would be willing to travel).

The most important thing is that you stay calm. Nothing that you have told me thus far sounds overly serious but your symptoms of shortness of breath coupled with your echo findings do require a thorough evaluation.

Hope this helps.

Best,

Dr. Rich

3 Comments
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Avatar_m_tn
Thank you for your comforting and informative response.  Even though I have had a pacemaker since Oct. of 99, I have never heard of tricuspid regurgitation from the lead being a possibility until now.  So that is good information to have.

Also, one of my lab results showed my ferritin level at 8.4, where the norm is between 13 to 150, so I will have a follow-up on that and that can be one of the main reasons I am short of breath.

I am now undergoing testing at the PH Clinic at the University of Iowa and will have the right heart cath on Monday to rule out PH for sure.  Then I can go from there.

Thank you again for your post and if things don't go well at the U, I will make a trip to Chicago!!

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Avatar_m_tn
Heart cath results showed normal pressures:  no PH.  Now I need to beef up my iron, get back to exercising and get another look at my tricuspid valve with the lead in it to see how severe the regurg is.

Thank you once again for your help!
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This Forum's Experts
1884349_tn?1353818598
Jonathan D. Rich, MDBlank
Northwestern Memorial Hospital
Chicago, IL
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