Pulmonary hypertension information, please help: (?
A little over five years ago, a doctor told me I had pulmonary hypertension (46mmgh on echocardiogram). Since then I married and had a child, and in 2007 I went to another cardiologist for another echo and he said IF you have PH it is very mild (24mmgh by echo).
Skip to 2009, I am now in my second pregnancy and the condition came up again (59mmgh by echo). Today I went in for a f/u echo and the doctor said “you definately have pulmonary hypertension”; but then he asked “did they give you a green light to become pregnant?” and I explained that they told me I didn’t have it. So I asked him if the pressures were high, and he said that PH could not be diagnosed by that type of echo (same type where they measured peak pressures of 59mmgh) and that they would need to do a catheterization to confirm the diagnosis.
So I’m very confused; on one hand he says I have it on the other he says it can’t be diagnosed by echo–in ’04 they said I had it, in ’07 they said I didn’t, and now they’re saying I do. It seems like every time I have a test done something different pops up, the tech told me that this condition will never go away and that it doesn’t go away. So what’s right and what’s not? Is it diagnosed by echo or cath? Could the echocardiogram be wrong? I am getting the written report and taking it to the cardiologist who is currently treating me, but I wanted to do a little research to be better prepared. Please help if you can, thank you.
Thank you for your answer; I’m actually being treated at a teaching hospital right now and still unclear of what the true diagnosis is 
The first two doctors were private practices.
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I’ve been getting the same run around. My regular Dr. told me that a lot is not known, so maybe it’s all just opinions. I have not had the catheterization, so I don’t know about that. Basically my understanding is that the artery between the heart and lungs gets inflexible and causes fluid to build in the lungs. I’ve had fluid in my lungs most of my life and it has been diagnosed as a lot of different things (nearly 50 years), so I tend to just pay attention to how I’m feeling at the moment. Since sleep apnea was also diagnosed I have a c-pap machine and an oxygen concentrator. I make sure I use it if my lungs feel wet. It seems to help. Good luck!
P. S. Maybe try a teaching hospital where the tests are based on need not how much the Dr. can make off it? Not all docs are crooked, but some are trying to cover the bases with their insurance more than looking after you.
well
It is not necessary to do Catheterization confirmation
Echo. is sufficient to make the degree of hypertension . I f less than 60 mmHg,you can continuo your pregnancy with regular medical follow up. Also the cause must be clarified
best wishes
echo is not the most reliable approach for diagnosis of ph. it relies on various formulae and pressure gradients, and all other things being equal, ive never met 2 patients the same, 2 Dr’s the same, hence, your results are never the same. cardiac catheterisation is the only accurate method, but there are risks involved. if you are normally fit and well, (no blue lips, no shortness of breath, no repeated chest infections), then i would leave well alone. a normal pulmonary artery pressure is 15-30 (mmhg). in my opinion, pregnancy places extra pressure on the chest cavity, and i would be surprised if that pressure didn’t put in an appearance somewhere.
Your pulmonary hypertension may be secondary to the increased circulatory volume present during pregnancy. Be sure you follow up closely with your ob/gyn to monitor for any signs of pre-eclampsia, which can create pregnancy-induced pulmonary hypertension. If you are not with symptoms, than do not worry. As long as you can breath when you lie down, do not have serious swelling in your extremities, and are not awakening gasping for air (as well as what the previous answerer noted) than you need not be concerned at this point.
In our practice, if you were asymptomatic, we would absolutely not recommend biheart catheterization (they actually have to use 2 catheters for diagnosis, one venous one arterial) until after your pregnancy is completed. There is primary PAH which may be secondary to your pregnancy or genetics, and there can be pulmonary reasons (COPD, fibrosis, or #1: sleep apnea), and it can be due to valve abnormalities (severe mitral regurgitation or stenosis).
Before going forth with a biheart cath – you should talk with a pulmonologist who can do a non-invasive sleep study to see if you have apnea, which can easily be treated without adding excessive risk to yourself or your child.