post heart cath

[lori353]

I am a 46 year old female with a 2 year history of progressive SOB, dizziness, cough, chest congestion. Echo done in 2007 showed pulmonary pressure of 44. RHC done and it was normal. Repeat echoes were done q6monthes and the pressure remained the same until March of this year when I felt more SOB. Echo at that time showed a pressure of 50 otherwise all measurements were normal. Specialist said clinically the only thing he could find was a heart murmur that could be indicative. BNP level went from 14 to 80. He repeated the heart cath with exercise. Resting pressure was 30/8. Normal. He had me lift weights and had a hard time getting my heart rate up as I am taking beta blockers for tachycardia. Eventually he got my heart rate up to 110 and I stopped due to fatigue. It has been deemed normal. My questions are: If I don't have PH, should the heart murmur be investigated? Is the slight increase in the BNP mean anything? Do you think the exercise portion was accurate due to my being on beta blockers? Is it reasonable to continue to do repeat echoes in the future or could I safely close that door?

[Cleveland Clinic]

I am not sure if the pressures you mentioned are PA or RV pressures. If they are RV pressures then you most likely do not have pulmonic stenosis, but if these are PA pressures, then you don't have PH, but may have a degree of pulmonic stenosis, which limits that amount of blood entering the lungs and causes premature shortness of breath.
I don't think an increase in BNP in that range is of any significance.

[lori353]

Thank you. My RV pressure was 27/0.  so you think that the exercise portion was adequate at getting my heart rate up to 110? I have read so much that states that it is better to use a bike or treadmill. Also, on my last echo the pressure reading said "50 at least". Can you explain that?