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Pulmonary Hypertension

Pulmonary hypertension

07/08/2005

Question:

1.What are normal limits of systolic,diastolic and mean pulmonary pressures(taken by echocardiogram)in average men between 45 and 50 years of age? 2.What are normal pulmonary pressures taken during and post exercise stress-echocardiogram test?3.Does being anxious and nervous (as with BP white coat syndrome)during echocardiogram test causes pulmonary pressures to be higher?If yes by approximately how much?4.Would chest or cardiac mri be better tests to measure and diagnose pulmonary pressures than echocardiogram?If no what is the best non-invasive test or tests other than catheterization?5.Does the size of large pulmonary arteries and veins causes pulmonary pressures to be either higher or lower?If yes what are normal limits for both right and left pulmonary arteries as well as veins?Thank you

Answer:

Only the systolic pulmonary artery pressure can be estimated by the echo, and normal is up to 25.  The systolic pulmonary artery pressure will increase some with stress echo and does not always mean pulmonary artery disease. There is no consensus on the  abnormal cut off on stress echo. MRI is a useful screening test for Pulmonary Hypertension, but cardiac MRI is not routinely available at all the centers. With the expertise, it is better than the echocardiogram.  The cardiac catheterization is needed to confirm the diagnosis and decide therapy. The pulmonary arteries are increased in size in pulmonary hypertension, but this is not a good way to diagnose pulmonary hypertension.

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Response by:

Namita   Sood, MD, FCCP Namita Sood, MD, FCCP
Associate Professor of Pulmonary, Critical Care & Sleep
College of Medicine
The Ohio State University