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Thursday, October 2, 2014
Echo Findings Suggest Pulmonary Hypertension
I am a 59 year old female. My doctor ordered an echocardiogram to document a newly heard heart murmur. He was surprised to learn that the report showed mild to moderate pulmonary hypertension. He did not mention treating it at this time but will follow up with another echo in a year. When I began to research PH, I grew concerned that I should see a specialist to get to the root cause. I have been on cpap with 1 liter of oxygen for 2 1/2 years for obstructive sleep apnea, but still feel fatigued during the day. I have leg and ankle swelling and occasional mild shortness of breath upon exertion. Some of the findings on the echo are:
Trace mitral regurgitation is present. Mild tricuspid regurgitation is present. Increased RVSP suggests mild to moderate pulmonary hypertension. The left atrium is moderately dilated. Normal diastolic left ventricular function is seen. The left ventricle is normal in size; left ventricular ejection fraction is hyperdynamic (73%). The right atrium is mildly dilated. The right ventricle is moderately dilated. Right ventricular systolic function is normal. The inferior vena cava is moderately dilated. Estimated PSAP: 31.3 mmHg Estimated Rap: 10 mmHg Estimated RVSP: 49.69 mmHg
In your opinion, do these findings warrant further testing such as right heart catheterization, or should I not be concerned unless further symptoms develop?
The echo does suggest an increase in pulmonary artery pressures. I would discuss a referral to a specialist with your physician.
Namita Sood, MD, FCCP
Associate Professor of Pulmonary, Critical Care & Sleep
College of Medicine
The Ohio State University