PULMONARY HYPERTENSION

[gail882]

I had a right heart cathertirization in August 2011 and was diagnosed with a mean pulmonary pressure reading of 23, the heart consultant told me I had pulmonary hypertension. However having been referred to a specialist hospital (Hallamshire) I was told although this was a high normal reading for someone of my age (40) it had to be 25 or above to be diagnosed as having pulmonary hypertension.

I now have to go back in a few days to have another angiogram to clarify if the pressure has gone up etc.

The problem is I  am suffering breathlessness, pains in the rightside of my chest and shoulders and upper neck area, dizziness on exertion and when fresh air hits me when walking etc.  The symptoms I am experiencing is almost like angina I think although not sure what angina should feel like.

These symptoms can also come on for no reason.

I am wondering could I have borderline pulmonary hypertension and is there such a thing.

I would welcome anyones advice please?

[David Tinkelman, M.D.]

The specialist who described your pulmonary artery pressure as high normal is correct.  It is a borderline value, between high normal and abnormal.  The symptoms you have experienced are consistent with the diagnosis of Pulmonary Hypertension.  However, it would be uncommon to have the intensity of symptoms you describe with pressure in this range. Assuming that the pressure has not risen significantly since August, the pressure itself in this range, poses no immediate threat, but the cause of it may be serious and the current mild elevation a sign of a serious cause.  Thus your doctors following up with you now, is exactly what should be done.  An important aspect of establishing the cause of PH is a good review of your life style and medical history, to see if you have one or more risk factors.

What is most important at this time is for your doctors to first confirm the diagnosis as planned, and then to determine the cause:  is it Primary Pulmonary Hypertension or is it so-called Secondary Pulmonary Hypertension, the most common causes of which include recurrent pulmonary emboli (clots to the lung), disease of a heart valve, or estrogen or appetite suppressant therapy.

While pulmonary hypertension is a somewhat common disease, the cause may not immediately evident to one’s doctors.  Because of the frequency of this disease, many academic medical centers have established PH Clinics, staffed by physicians with an avid interest and great experience with the disease.  Should you prove to have a further rise in pressure at the time of the repeat right heart catheterization and if your doctors remain at all uncertain of the cause, you and they would do well to seek consultation at a PH clinic, without delay.

Good luck

[gail882]

Thankyou for your comments. They were very helpful.

Gail

[gail882]

Thankyou for your comments.

Gail

[gedankenkatze]

Hi,
I am a Japanese physician specialized in pulmonary hypertension.

Borderline pulmonary hypertension (PH) is a new problem in the medical science. Many specialists consider that borderline PH may be an early stage of this disease.  But, of course, it has been observed that some patients with borderline PH never develop life-threatening PH.  Future risk of borderline PH cannot be assessed by current medical science.  

I feel that your symptom is consistent with PH. Therefore, I recommend you to keep with some specialist in PH-specific hospital in your country or state.

Thank you.