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Tuesday, July 22, 2014
Pulmonary hypertension with RA
I have rheumatoid arthritis and recently diagnosed with systemic hypertension possibly secondary to meds. My rheumatologist recently ordered a echo for a possible murmur, and the echo showed mildly elevated pulmonary pressure in the range of 35-40 mmHg with tricuspid regurgitation. There were no significant abnormalities, but borderline lvh, trivial mitral regurg and trivial aortic insufficiency. I have not been told that I have rheumatoid lung disease and my chest xray is normal.I have a BMI of 38, but do not have sleep apnea. My doctor plans to repeat the echo in 6-8 weeks. I`ve seen answers on this board that state that pulmonary hypertension is rare in RA, however, I`ve found scholarly articles indicated that elevated pulmonary pressures have been found in 28-31% (depending on the article) of RA patients. Why is it considered rare?
Pulmonary hypertension is rarely associated with rheumatoid arthritis. However, systemic hypertension can lead to stiffness of the heart (diastolic dysfunction of the left ventricle) that may cause the elevated PA pressure.
I would suggest control of your blood pressure, weight loss, and if the echo is still abnormal, a right heart catheterization to see if the pulmonary artery pressures are truly elevated .
Namita Sood, MD, FCCP
Associate Professor of Pulmonary, Critical Care & Sleep
College of Medicine
The Ohio State University