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Pulmonary Hypertension

Elevated PASP

10/26/2010

Question:

I`m a 57 (3 weeks shy of 58) year old VERY fit male. I`m 5`4 and weigh 128 lbs. I have a life long history of irregular heartbeats starting in my teens. At 39 I went into atrial fib after a work out. I`ve been on digoxon (0.25) and atenolol (25 mgs) ever since. I don`t smoke, drink, do any illicit drugs. I jump rope strenuously an hour a day, and do 500 push ups a day, 6 days a week, and have been doing so for MANY years, with no symptoms of something being wrong. Going in for my annual physical last year my doctor wanted me to get an echocardiogram being I hadn`t had one in years. It came back showing I had mild P.H. with a level of 39 mmhg. I was worried about it, and decided almost a year later (last week) to go back to a heart doctor, and he asked me if I`d mind getting another echo. I said I would and did. The results of this one says I now have moderate pulmonary hypertension, with a level read at 46 hhmg! I have mild to moderated mitral valve regurgiation and have for years. I also have what the echo called mild tricuspid regurgiation. My question is would I be symptomatic if I had moderate pulmonary hypertension, and is there any way I could possibly exercise like I do without symptoms if I did have it. I`ve read where PASP increases with age and exercise. I`m just wondering if this could be the case or should I be concerned. I don`t have the money to spend on a bunch of tests that might not be necessary. A response to this question would be greatly appreciated! Thank you ahead of time!

Answer:

It is hard to interpret to the echocardiogram since you feel so well. The pressures on the echo can vary and are not always accurate. Pulmonary hypertension (high pressures in the vessels in the lung) can be a result by many different processes. You mention mitral regurgitation too, which can lead to pulmonary hypertension if it is significant. I would discuss the echo with your cardiologist who will be able to look at the images and tell you if additional testing is required.

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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