Your Echocardiogram: Do You Need Further Testing for Pulmonary Hypertension?

Echocardiogram Report

Hello, doctor.
In 2020, I had an echocardiogram that indicated pulmonary hypertension, but the physician did not inform me, did not prescribe any medication, and did not recommend further testing.
Currently, I do not have any symptoms of pulmonary hypertension such as shortness of breath, swelling, dizziness, or cough, and I feel fine.
Here is my report:
Echo No:
Clinical diagnosis:
M-Mode and Sector scan:
Aortic root (2.0-3.7 cm): 3.16
LAD (1.9-4.0 cm): 4.72
IVS (0.6-1.0 cm): 1.33
LVIDd (3.5-5.7 cm): 4.44
LVPW (0.6-1.0 cm): 1.28
LVIDs (2.8-3.5 cm): 2.96
EF (50 - 83 %): 62.2
FS (28 - 44 %): 33.3
RV (0.6-1.0 cm): 1.

AV: Normal
MV: Normal
PV: Normal
TV: Normal
Regional wall motion: Fair
Pericardial effusion: Absent
Others:
Global function:
Technical difficulty:
Doppler/Color Flow Findings:
AR: Mild
MR: Trivial
PR: None
TR: Mild
AS: None
Mean P.G: 0.0 mmHg
Peak P.G: 0.0 mmHg
AVA: 0.00 cm²
MS: None
Mean P.G: 0.0 mmHg
Peak P.G: 0.0 mmHg
MVA: 0.00 cm²
TS: None
Mean P.G: 0.0 mmHg
Peak P.G: 0.0 mmHg
TVA: 0.00 cm²
PS: None
Mean P.G: 0.0 mmHg
Peak P.G: 0.0 mmHg
PVA: 0.00 cm²
Estimated PASP: 37 mmHg
E/A ratio: Normal
Shunts:
Others:
Comment:
1.
Dilated LA
2.
Concentric
Could you please advise if I need further testing or medication? I am currently asymptomatic.
Thank you.

Heifetz, 50~59 year old female. Ask Date: 2023/05/17

Dr. Li Shengkai reply Cardiology

According to your echocardiogram report, it indeed confirms the diagnosis of pulmonary hypertension.
Further examinations can be conducted to check for other pulmonary diseases, thromboembolic conditions, or rheumatologic and autoimmune disorders.
If pulmonary hypertension is asymptomatic, medication may not be necessary, as most treatments for pulmonary hypertension have significant side effects, and they are only used when the benefits clearly outweigh the risks.
The treatment of pulmonary hypertension is complex, and specialized teams to monitor patients are typically established only at medical centers.

Reply Date: 2023/05/17

More Info

Based on the echocardiogram report you provided, it appears that you have an estimated pulmonary artery systolic pressure (PASP) of 37 mmHg, which is above the normal range (typically considered to be less than 30 mmHg at rest). This finding suggests that you may have mild pulmonary hypertension. However, it is important to note that the presence of pulmonary hypertension does not automatically necessitate treatment or further invasive testing, especially if you are currently asymptomatic and not experiencing any related symptoms such as shortness of breath, swelling, dizziness, or cough.

In your case, the echocardiogram indicates that your left ventricular ejection fraction (LVEF) is within a normal range (62.2%), and there are no significant abnormalities noted in the heart valves or regional wall motion. The mild tricuspid regurgitation (TR) and trivial mitral regurgitation (MR) are also not uncommon and may not require specific treatment unless they become more severe or symptomatic.

Given that you are not experiencing any symptoms associated with pulmonary hypertension, it may be reasonable to adopt a watchful waiting approach. However, it is essential to maintain regular follow-ups with your healthcare provider to monitor your condition. Your doctor may recommend periodic echocardiograms to track any changes in your pulmonary artery pressure or overall cardiac function.

If you begin to experience symptoms such as increased shortness of breath, fatigue, or any other concerning signs, it would be prudent to seek further evaluation. In some cases, additional testing such as a right heart catheterization may be warranted to obtain more accurate measurements of pulmonary artery pressures and to assess the severity of pulmonary hypertension.

In summary, while your echocardiogram indicates mild pulmonary hypertension, the absence of symptoms suggests that immediate intervention may not be necessary. Regular follow-up with your healthcare provider is crucial to ensure that any changes in your condition are promptly addressed. If you have any concerns or if your symptoms change, do not hesitate to reach out to your doctor for further evaluation and guidance.

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