Echo PAP 40

[Barbie3961]

I had an Echo done and all my numbers come back in the normal range with the exception of Pulmonary Pressure. It came back 40. I had a normal X-ray thats states no acute cardiopulmonary disease.
Aortic root shows some mild sclerosis. Arotic valve is normal. The valve is tricuspid. The valve is normal morbidity. No vegetations are seen.
Mitral valve is normal with mobility with some thickening of the leaflets. There is no mitral annular calcification. There appears to be mild mitral valve prolapse.
Tricuspid valve is grossly normal
Pulmonic valve is grossly normal. There is trace pulmonary insufficiency
Left ventricular dimensions show normal chamber size.  LV wall thickness is normal. There is normal left ventricular contractility.
Right ventricular dimensions show normal chamber size. RV wall thickness is normal. There is normal right ventricular contractility.
Left atrial size is normal.
Right atrial size is normal
There is no pericardial effusion
IVC is normal with respiratory variation
Findings
Dimensions
Normal
Ejection fraction 63%
Normal chamber sizes with no evidence of ventricular hypertrophy
Trace pulmonary insufficiency with mild mitral and tricuspid regurgitation
Normal diastolic function
Some thickening of the mitral valve leaflets with mild mitral valve prolapse.
Mild pulmonary artery hypertension?????

With all these normals how can it be pulmonary hypertension?

I did have a pulmonary test and it came back mild Copd. could this cause the dx?

Thanks for any help to figure this out. I am pretty freaked out. I just recovered from Breast cancer two years ago.

[Jonathan D. Rich, MD]

Hello Barbie and my apologies for this very delayed response.

Im not even sure why you had an echo in the first place but based on the echo results, I suspect that you may indeed have mild pulmonary hypertension (though you may not have it all given how unreliable echo can be).  However, even if you did have mild PH, it is not something in and of itself that you should be worried about. I am almost certain that you do not have PAH (ie the type of PH that is lifethreatening, etc).  IF you have PH at all (need a heart cath to know for sure), I suspect it is simply related to getting a bit older, maybe having borderling high BP, being a bit overweight, and/or any previous smoking you've done with some lung disease, etc etc.  In other words, sort of a combination of everything.


Your focus should simply be on continuing to stay active and living a healthy lifestyle along with routine medical care.

All the best,

Dr. Rich

[Bichonlady]

The literature does say that COPD could lead to Pulmonary Hypertension.
The plus is that both are mild and the Dr. needs to address the COPD more aggressively so there is not so much work put on the heart and Pulmonary artery.