Pulmonary Hypertension

I had a stress echo that showed a moderate pulmonary hypertension with a pressure of 42 mm/Hg, moderate tricuspid regurgitation, mild right ventricular dilation, and mild mitral insufficiency.  I had an echo three years ago which showed none of this, also I've developed an ejection systolic murmur in the upper left sternal border where s1 is greater than s2 and s2 is split.  

1. I know the next step is catherization to diagnose hypertension, but do you know of other problems this could be?      

2. Is a stress echo usually accurate when it comes to reading pressures?  I've heard that pressures are lower than catherization and I've also heard they're higher?

3. If the right ventricle is mildly dilated, how long will it take to have full heart failure?  What do you think my life expectancy is?  I'm only 32.    

4. Why does pulmonary hypertension cause you to be so tired and breathless?

Thanks for your help.  I really do appreciate it!  It's hard to find a good doctor these days, and you are doing a good service for people.  

[National Jewish]

The facts presented suggest that you have developed pulmonary hypertension.  The ECHO is a good tool for the detecting pulmonary hypertension.  It also gives a good measure of its severity.  There are many causes of pulmonary hypertension.  This includes problems of both the heart and the lungs.  The first step is to find the cause.  Then and only then might it be possible to answer your questions about the rate of progression and the prognosis.

Pulmonary hypertension makes you tired and breathless because it increases the work of breathing.  It also decreases the capacity of your heart to pump blood to your vital organs.

There are many medical centers, now actively engaged in the diagnosis and treatment of pulmonary hypertension.  You should seek consultation at one of these.

Please post your question with the Heart Forum at http://www.MedHelp.org.  The cardiologists at the Cleveland Clinic Heart Center answer these questions.  They have more experience with pulmonary hypertension.