I am 26 years old (no history of asthma or respiratory illnesses) and 20 wks preg with a singleton and have been experiencing Sob upon exertion, which lately has progressed to being sob just getting up and walking, palpitations, tachycardia (upon standing increases to 130 and stays elevated but will drop upon sitting) and now chest pains. I went to cardiologist, ordered echo and holter. Holter came back normal. Echo came back with mildly thickened and myxomatous mitral and tricuspid valve with trivial regurgitation and RVSP of 33 (at rest). Now what concerns me is the borderline increased PAs, doctor said it was increased due to preg and that he would recheck 6 months AFTER delivery (really 10.5 months from now), however Im pretty sure PAP doesn't increase due to pregnancy and that this some what elevated. Should I be concerned and get a second opinion? *Also I had an echo done 7 months prior, just got a copy of my results and everything was normal except for trivial regurgitation in mitral and tricuspid valve, I also delivered twins the day before (had SVT) so if my findings are pregnancy related wouldn't that echo have similar findings?
I am going to comment only on the question of the pulmonary hypertension. I will defer the evaluation and interpretation of your symptoms to your physician (they may be simply normal pregnancy symptoms but without sufficient information, its better that I not comment).
Now for the good news: on the basis of what you told me, I have no concerns over the results of the echo. ASSUMING the echo data are accurate (and echo has its limitations), an estimated RVSP of 33 mmHg in anyone, particularly someone pregnant is not concerning to me in the least. In fact, contrary to what you were told (but as your doctor correctly pointed out), pressures can indeed go up marginally in pregnancy because pregnancy induced a high cardiac output state (ie more blood flow circulating because after all, there's a little bugger in there that needs some blood too now). So if the right ventricle overall looks ok and with an RVSP of 33, take a deep exhale, move one, and enjoy your pregnancy.
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