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Pulmonary Hypertension Forum
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Avatar universal

Second opinion to rule out PH

I am a 40 year old female with high blood pressure that is controlled by medication and diet.  In January I started experiencing some shortness of breath and mild chest discomfort, slight dizzy feeling when standing up or bending over.  I first noticed it while at the gym.  My primary physician sent me for some testing. Chest X-ray which showed the appearance of small airway disease.  I was a smoker but I quit 4 years ago. The myocardial perfusion (stress test) was pretty good, only noted fixed anteroseptal and apical defects which the doctor said was most likely due to breast  attenuation.  The echo showed mild tricuspid regurgitation, elevated right ventricular systolic pressure, mild pulmonary hypertension and Dilated IVC with poor inspiration collapse which is consistent with elevated right atrial pressure.  Chest CT was unremarkable.  I have a breathing test this week.  I went to a cardiologist as per my doctor’s request, he was mildly concerned with the findings and wanted me to see a specialist.  The cardiologist said that yes I have mild pulmonary hypertension but it’s reversible, since I quit smoking, the chest discomfort and shortness of breath were okay and I needed 20 to 25 minutes of vigorous exercise each day and I needed to eat on a set schedule and to make sure I ate a banana every day.  He said maybe it was stomach spasms. Other than that I’m a normal weight female so he didn’t see a reason to follow up.  I asked if he was sure it was mild pulmonary hypertension and what could I do to help myself and he said just exercise and eat right. My question is should I get a second opinion? I have read that pulmonary hypertension shown on an echo has a high false/positive. Maybe someone who specializes in this disease so I can rule it out. I just want to feel better and this is annoying.
2 Responses
1884349 tn?1353818598
MEDICAL PROFESSIONAL
Hello and welcome to the forum.

You are asking exactly the right questions.

1. Yes, seek a 2nd opinion with a TRUE PH specialist.  This is not to concern you--in fact, its to give you peace of mind.

2. Cant diagnose PH without a RHC.

3. Agree with quitting smoking, exercise, healthy diet, etc etc.  But frankly this goes for all of us!!

4. Stomach spasms?   puleez

Please feel free to keep me posted.  If you are in the midwest, I'd be happy to see you.

Best,

Dr Rich
Avatar universal
Hi Dr. Rich,

Just to follow up in my progress to date. I did some research and got a recommendation for a doctor who specializes in Pulmonary Hypertension, I live in New Jersey and it was difficult to find a doctor relatively close. I followed up with him today, and I was extremely impressed with his approach.  He first spoke with me regarding all the tests I've had done, he then examined me and had me do a 6 minute walk test and then another breathing test.  Unfortunately I did not do as well as he would have liked on the 6 minute test, I completed the test but my oxygen saturation dropped to 89 during the test.  After the testing we discussed the next steps which is to get a blood work up, pulmonary exercise test, and  ventilation-perfusion scan.  I have to complete these within the next two weeks and then go back to see him to discuss the results.  He said ultimately I will need the right heart cauterization but he would like to have a full picture to work with.  He felt very positive that we may have caught this early if it is pulmonary hypertension but he wants to move quickly so we can plan an aggressive treatment plan.  I will update when I have more.  I appreciate your advice and I'm really glad I did go for a second opinion.

Thank you!
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