Borderline Pulmonary Hypertension

[stampingamy]

My husband, 42, had an EKG during a routine physical that indicated an enlarged L atria of the heart.  He was referred for an echocardiogram.  The results showed a diagnosis of "borderline pulmonary hypertension."  He currently isn't feeling any symptoms.  His LA Diam was 4.1, TV Pk Vel was 2.67 and the PV PkVel was 1.3.  The doctor says that overall this is a normal reading and the tricuspid regurgitation rating can be incorrect.  The right ventricular systolic pressure is estimated to be 35-40 mmHg.   We are still concerned.  He is 5'7" and weighs 165 pounds.  

Is this a normal reading or does he have pulmonary hypertension?  Will the eventually turn into a more serious condition?

Thanks,

[kaylynd43]

A related discussion, Pulmonary hypertension was started.

[National Jewish Health]

Your husband's doctor is correct that the value can be elevated to the point of being invalid, in the presence of tricuspid regurgitation.  Given this it would be prudent to not conclude that your husband has pulmonary hypertension.  You mention that the finding that led to the echocardiogram (ECHO) was an enlarged left atrium with a diameter of 4.1 (normal 1.9-4.0), your husband’s is at the upper limits of normal.  Pulmonary hypertension does not cause enlargement of the left atrium.  However, elevated pressure in the left atrium, as is seen with mitral stenosis or insufficiency can result in an enlarged left atrium and pulmonary hypertension.  You should ask his doctor if he believes the left atrium to be normal or enlarged and, if enlarged, what he believes to be the cause?

Further testing may be required to resolve this question.

[tonpitts]

I have just recently been told that on echo my systolic pulmonary pressure was 33mmHg.  (which they called minimal)  Which anything over 30mmHg is suppose to pulmonary hypertension to some degree...However, in doing my research I have found that the ONLY way to know for sure if you have pulmonary hypertension is to have a right heart catherization done.  I think If I were your husband I would inquire about that...