Is this pulmonary hypertension

[Verynervous11]

Please help!!! I had a noticed a few extra heart beats here and there.  My dad had open heart in December to repair his mitral valve, he was 58 and had severe regurg.  He recovered and all is well.  Well do to that hx I decided to get a cardiac work up.  My EKG showed a few depolarizations the cardiologist said it was completely normal and ordered a stress test which was unremarkable a holter monitor which was also fine but my echo showed the following:

Left and right ventricles : normal
Left atrium : normal
Right atrium mildly enlarged 4.1 normal range 2-4.0
Mild MVP with trivial regurg
Tricuspid trivial regurg

Jet 2.9
Pressure gradient 33
Rvsp 43

Mild/mod pulmonary hypertension.  I'm a nervous wreck and my cardiologist basically said yes it's pulmonary hypertension and follow up with a pulmonologist to find the cause.  I'm 34  female, 50 pounds overweight.  The entire echo was only 10 minutes and the tech put "sub optimal image quality due to body habitus" also I had major anxiety during the test, my heart rate is usually in the 60's it was 120 .. My blood pressure at home is always normal 125/78 during the test it was 160/90.  Can these factors change the pressures or make it difficult to assess?  Thank you

[Jonathan D. Rich, MD]

Yes, anxiety/stress/tachycardia can all contribute.  I highly encourage you to do anything you can to get your stress under better control.  Also, weight loss, etc etc can def help to prevent problems from developing in the future (including PH which you do not have).

[Verynervous11]

Thank you so much! I haven't been able to sleep.  If I had a repeat echo could the number be lower and also could severe stress, anxiety and tachycardia during the echo cause an increase in the pressure reading?

Also of the pressure is truly elevated and I lose weight can that correct the problem before symptoms of PH begin? I truly appreciate your time .

[Jonathan D. Rich, MD]

Hello and welcome to the forum.

1. Take a deep breath (now take another)...good, you're gonna be ok!
2. You have no symptoms (Im not worried about he occasional extra heart beat) and you're echo from what you described sounds essentially normal.
3. You do NOT have pulmonary arterial hypertension.
4. You may have mild "pulmonary hypertension" associated with being overweight and some other factors that are easily correctable.  In other words, the PH (if it even exists), is not something to worry about.  Losing weight, treating sleep apnea if you have it, treating high blood pressure or DM, etc etc are the things to do in these instances.
5. So, if in some way you use this "scare" to get a little healthier, you'll prob look back and realize this was a good thing.  But again, there is nothing you told me that makes me think you have the type of pulmonary hypertension that is worrisome.

Hope I've helped.

Best,

Dr. Rich

[Verynervous11]

Sorry it was left  atrium that is mildly enlarged at 4.1

Right was normal