Upsetting echo results

[Drea811]

I am a 32-yr old female, 5'7", 128 lbs. Recently I had been experiencing rapid heart beats (sometimes 180 and up to 200 bpm) after exercise , usually running. I went to see a cardiologist who ordered an echo as well as an EKG. While the findings were mostly normal, he did find a few things of concern:

1) "mild to moderate" tricuspid regurgitation
2) a slightly enlarged right ventricle (he described this as very mild)
3) estimated pulmonary pressure in the right ventricle of 30-35 mmHg

Now I am scared to death that I could have pulmonary hypertension, which does not seem to have positive prognosis at all. What could these findings mean? And, could they be the cause of the rapid heartbeat issue? I have been having occasional dizziness and SOB, but certainly nothing I would have flagged for a physician prior to getting these results.

I should also mention here, as it seems relevant, that I do have (mild) chronic airway obstruction due to asthma and just recently began Flovent treatment. I also recently had a flareup on my neck of a red, scaly patch of rashes that my derm diagnosed as eczema, which I am now (hypochondriacally I'm sure) concerned could be some indication of sclerosis or some connective tissue disorder related to PH.

I will be seeing a pulmonologist in the near future for further follow up, but I am filled with anxiety about this and trying to get as much info as I can prior to the appointment. Thanks in advance for any insight.


Andrea

[Drea811]

Thank you for your reply. One follow-on question: can mild PH exist without future problems, eg not progress and not cause heart failure? Everything I have read on the topic seems grim. I did indeed ask my physician and he indicated he doesn't know what the problem is. However he did not want to rule PH out and suggested I refer to a pulmonologist for testing. I am sure he is trying to be thorough, but this has made me anxious nonetheless. I appreciate your response.

[Michael J. McWilliams, M.D.]

Andrea,
That is tricky because I can't see the images.  I can tell you that assessing RV size is tricky and often depends on the angle you see on the echocardiogram.  

Pulmonary pressures of 30-35 mmHg are not that high.  By some scales that is mild pulmonary hypertension.  Don't take a common finding like tricuspid regurgitation and mild pulmonary hypertension and extrapolate that into some life threatening condition.  If your doctor thought you had that they would have told  you. The best approach is to ask them exactly what they think is causing it.  They will probably tell you that they don't know but they don't think it is life threatening -- that would be a very honest answer.

A 30 day event monitor is indicated if the 24 hour holter is normal. The only way to assess the fast heart rate is to see it on a monitor.

Again, a direct question to your physician about whether a condition is potentially life threatening is probably the easiest way to ease your anxiety.