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Tuesday, September 16, 2014
High Blood Pressure
Could you explain these results for me?
STUDY CONCLUSIONS SUMMARY - RIGHT VENTRICLE : Mildly dilated. Normal systolic function. The estimated peak RV systolic pressure is mildly increased. - LEFT VENTRICLE (SEPTUM) : Normal chamber size. Normal systolic function. - PULMONIC VALVE : There is increased flow across the pulmonic valve at the level of the RPA. The pulmonic valve is not well seen but has a normal velocity at the level of the valve. The pulmonic annulus was not well seen. The pressure gradient across the pulmonary artery is 31 mmHg. The estimated PASP is 14 mmHg (RVSP 45-pressure gradient 31). IMPRESSSIONS Study is consistent with branch pulmonic stenosis at the level of the RPA. There is no evidence of tetralogy of fallot or transposition.
The echocardiogram report shows normal left ventricle and function. However, the pressure in the right ventricle is slightly increased at 45 mmHg (normal is 15 to 30 mmHg). There is increased flow across the right pulmonary artery and a pressure drop across the pulmonic valve (the valve between the right ventricle and the pulmonary arteries). Normally, the systolic pressure is the same in the right ventricle and the pulmonary arteries.
Your echocardiogram results therefore show a slight obstruction at the level of the pulmonic heart valve. The most common cause of pulmonic stenosis is congenital. If the stenosis is severe enough, the pulmonic valve can be opened with a balloon or other techniques. You will need the advice of a cardiologist.
Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati