Pulmonary Hypertension

[sonja825]

I have been treated for several years for many varied symptoms and became acutely ill in Jan 06.  After 2 unsuccessful months of antibiotics at home in early 2006, I spent a week in hospital in 03/06 with pneumonia and dehydration. I had an echocardiogram because shortness of breath was a recurring problem. I was told the echo showed nothing significant. I continued to experience breathing problems sporadically since but the symptoms have become chronic since January 2008. They occur at rest as well as with minor activity and are affecting all aspects of my life. I have gained 25 lbs in two months with a great percentage of that in my upper abdomen where I seldom gain. I am 48 WF, 5'2", 138 lbs. I weighed 113 lbs right after Christmas. I have swelling in my feet, ankles, hands and abdomen. My physicians do not think the rapid weight gain is related to any present medications (of which there are many). For a number of years a constant complaint has been my heart "fluttering" in my throat occasionally which was diagnosed as tachycardia  but did not warrant treatment. Last week I had an ultrasound that ruled out PE's and another myriad of labs.

I learned the hard way to do as much research as possible on my own. I obtained a copy of the written echo report from 06 which states "Conclusion: Mild pulmnonary hypertension. (1).....left ventricular normal wall thickness and normal end-diastolic volume. Regional and global left vent systolic performance normal to hyperdynamic. Left vent filling pattern suggest impaired relaxation. ..........probably due to rapid heart rate present during study. .....confirmed by normal tissue Doppler interrogation of mitral annulus velocity. Right vent is normal in size and performance (2) atrial chamber dimensions normal (3) valves are normal in structure.  There is tricuspid regurgitation the peak velocity of which corresponds to a pulmonary artery systolic pressure in the low 40's".  Based on my limited research and knowledge, I do not think that is an "insignificant finding".  

I was finally diagnosed with MS on 07/30/07 and began weekly Avonex therapy 09/01/07.  My neurologist also prescribed Amitriptyline 25 mg to prevent migraines, Provigil 200 mg for fatigue, and Zrytec 10mg for a site reaction,  I was diagnosed with neurocardiogenic syncope in late '06 (on the table 16 min before passing out) and take Toprol XL 25 mg and Florinef .01 mg.  I have taken Synthroid since age 16; now at 75 mg.  I take Tricor 145 mg and Simvastatin 20 mg for uncontrolled cholesterol.  I am followed by a gastroenterologist for bowel problems for which I take Amitiza 2/day and Lactulose. I also take Wellbutrin 200mgSR 2/day and Clonapin 1 mg.

Please explain exactly what the echo report means.  In your opinion, does the report establish pulmonary hypertension that warrants followup or is it in fact insignificant? Do you think all the symptoms I described can be traced back to the MS? Thanks for your time!

sonja825

[sonja825]

Sorry; I made mistake the original post.  Provigil is to help me sleep at night.

[xavier9798]

I would request a right heart catheterization (RHC).  It is the definitive test for Pulmonary Hypertension.  Many doctors do not do a RHC, so check with your physician on the best specialist to go to for this.  If your pressures are elevated above 25, that confirms PH.  There are much better treatments for PH now than there used to be.  If you do indeed have PH, they may help you feel tremendously better.