ABPA

Hi
I'm a 54 year old with ABPA diagnosed 6 months ago, and a life long history of severe asthma. I recently had my blood pressure and pulse go out of control after many years of taking high blood pressure medication. My PCP sent me for an echocardiogram results are 1. Mild physiological regurgitation noted throughout mitral valve 2. Trace physiological regurgitation noted throughout the aortic and tricuspid valve  EF 64%. My breathing has gotten progressively worse I'm on oxygen 24/7 could these findings be contributing to my breathing problems even though my PCP feels that my echo was normal. I also had a normal echo last year with findings of 1. Trace mitral insufficiency with left ventricular inflow pattern consistent with diastolic dysfunction 2. Mild tricuspid insuffiency with estimated pulmonary artery systolic pressure of 30 mmHg  EF 55%.  

[National Jewish Health]

It is doubtful that the ECHO findings would account for worsening of your breathing, especially for the need for oxygen unless there is what is called, a right to left shunt.  With the information provided, it is much more likely that your worsened breathing is due to the asthma and allergic bronchopulmonary aspergillosis (ABPA).  That you require oxygen, 24/7, suggests significant pulmonary function impairment.  It would be most important to determine if the asthma/ABPA is being optimally treated.

The question of the relative contributions of lung disease and heart disease is a common one and not always easy to resolve.  In this case, however, the presumably resting, not stress, ECHO suggests clinically inconsequential abnormalities and the EF is impressive.

Our recommendation would be that you first ask your primary care provider (PCP) for a referral to a pulmonary specialist for an assessment of the magnitude of impairment, attributable to your asthma/ABPA.  If it appears that your lungs are not the primary or only problem, consultation with a cardiologist would be in order.