Tricuspid regurgitation and Pulmonary Hypertension?

[Auglaise]

I am a 56 year old female, 5'6" 120lbs. non-smoker. About a year ago I had a non-related chest X-ray which showed enlargement of cardiac silhouette.
     My doctor ordered an echo. Results: Estimated right ventricular systolic pressure 48mm/Hg. reflecting pulmonary hypertension. Also an interatrial septal aneurysm was noted.
     An ECG revealed possible right ventricular hypertrophy.
     The cardiologist said I should see a pulmonologist and take a baby aspirin daily.
     The pulmonologist ordered Pulmonary Function tests and blood gas tests which were all normal.
     I was sent to a doctor who specializes in pulmonary hypertension. Had more blood tests and ECG, all which were normal.
     Recently I had a bubble echo. Results: Normal global LV systolic function. Large RV, large interatrial septal aneurysm. A small amount of contrast seen crossing interatrial septum consistent with PFO. Moderate pulmonary HTN, with RV systolic pressure 53mm/Hg. All heart valves and chambers were normal except right ventricle was dilated. No hepatic flow reversal. Normal sinus rhythm. I had a six minute walking test and O2 saturation during exercise were normal. %SaO2 rest 100%, %SaO2 6 minute walk 97%
     It should be noted I have no symptoms of Pulmonary Hypertension. I exercise regularly and feel good except for worrying about some of these test results.
     The PH specialist tells me the only way to know for sure if I have PH is to have a heart catherization. She says it is up to me. What should I do? Also how accurate are echos?

[Auglaise]

Spiralz06

You need to relax first. I was told that an echo cannot say for certain that you have pulmonary hypertension, only a heart catherization can confirm pulmonary hypertension. Also I think you are talking about Primary or idiopathic pulmonary hypertension that can be fatal in a few years if not treated. Some people have secondary pulmonary hypertension that is mild or moderate and can be controlled or even reversed if the problem is found and corrected. That is why you had those other tests. I was told that I have tricuspid regurgitation, but that does not mean for certain that I have pulmonary hypertension. Only more tests will indicate what I have. Also my doctor mentioned l-arginine as an alternative treatment for pulmonary hypertension. It is an amino acid I think. It can be bought at Health food stores. But I would ask my doctor about it before I would take it.

Auglaise

[spiralz06]

Recently I was told I have Pulmonary Hypertension due to findings of an echo (done because of a possible murmur or MVP).  I don't believe I have shortness of breath, pain in chest, or any other symptom of PH so is there any way it could be something other than Pulmonary Hypertension? I was told it is mild to moderate and that I have had it for some time.  I have just begun tests:  spiral ct, stress echo, stress doppler, blood work etc and have not received results.  The information on the internet paints a bleak picture:  either way it is fatal.  And there is no cure.  Of course I am in shock for the level of energy I have is unreal. I do not have sleep apnea or anything that would affect lung output. I am just shocked. I went in for an annual check up and my doctor thought she heard something when checking my heart.  Is it possible I have always had a mild elevation? Without it leading to total death in a few years?  I am a 50 yo healthy female with digestive problems and a history of melanoma (1988).   And that's it.  A few fibroid tumors causing some mild anemia.  What is going on?? Now, I am afraid to move. Just knowing about this nasty disease is going to make me insane. I think I'd rather take my chances with the melanoma instead.  Thanks.

[Cleveland Clinic]

Auglaise,

Thanks for the post. Sorry to hear of your recent events.

An echocardiogram is pretty accurate to detect elevated pulmonary pressures. It is not precise though and can sometimes underestimate pressures.

Given your findings of elevated pressures and right heart dysfunction, I would assume that you have some element of pulmonary hypertension.  It is important to get to the cause of the pressures and the work up for pulmonary hypertension is fairly straight forward and important to elicit the underlying cause.

Depending on what is found a catheterization may be pursued to further define the cause such as cardiac shunts and to look for potential responses to therapy.

The most important thing is to find an experienced physician who can follow you over time.

good luck