Should You Monitor Estimated Systolic Pulmonary Artery Pressure of 34 mmHg?

Q: Should You Monitor Estimated Systolic Pulmonary Artery Pressure of 34 mmHg?

According to the definition, pulmonary hypertension is indicated when the pulmonary artery pressure exceeds 25 mmHg at rest or 30 mmHg during exercise. <br>Based on your echocardiogram report, the result was 34 mmHg, which should be monitored further. <br>Additionally, the report

The estimated systolic pulmonary artery pressure is 34 mmHg. Should this be monitored?

Hello Doctor, I visited the cardiology department last year due to chest tightness and palpitations.
The examination report at that time is as follows, and I would like to know if I should return for follow-up.
P.S.
My physical condition has been acceptable recently, and I have slowly gained about 5 kg in weight over the past year.
The palpitations have remained stable or slightly improved.
Examination Date: 2022/10/18
Conclusion:
• Normal sizes of cardiac chambers
• Preserved global contractility of the left ventricle
• No significant regional wall motion abnormality
• Normal diastolic function of the left ventricle
• Estimated systolic pulmonary artery pressure is 34 mmHg
• Mild tricuspid regurgitation (TR)
• Mitral valve prolapse
• EKG: Sinus rhythm
MMode/2D Measurements & Calculations:
Time Measurements
MM R-R interval: 0.76 sec
MMode/2D Values References:
Ao root diameter: 2.5 cm [2.0-3.8 cm]
LVIDd: 4.4 cm [3.7-5.3 cm]
ACS: 1.8 cm [1.6-2.6 cm]
LVIDs: 2.8 cm [2.4-3.6 cm]
LA dimension: 2.9 cm [1.9-4.0 cm]
EDV (Teich): 87.9 ml [80-180 ml]
RVDd: 2.0 cm [0.5-2.1 cm]
ESV (Teich): 30.3 ml [16-83 ml]
MV E-F slope: 10.6 cm/sec [8.0-15.0 cm/sec]
EF (Teich): 65.5% [50-70%]
IVSd: 0.81 cm [0.7-1.1 cm]
FS: 35.8% [FS 34-44%]
LVPWd: 0.90 cm [0.9-1.1 cm]
MM HR: 79.0 BPM [60-100 BPM]
[EPSS <0.8 cm]
CO (Teich): 4.5 l/min [2.5-7.2 l/min]
RWT: 0.37 [RWT 0.22-0.42]
Doppler Measurements & Calculations:
MV dec slope: 666.0 cm/sec²
Ao V2 max: 145.0 cm/sec
Ao max PG: 8.4 mmHg
TR max velocity: 244.5 cm/sec
Examination Date: 2022/10/18
Conclusions:
(1) Sinus rhythm was average with a heart rate of 78 BPM, a maximum heart rate of 168 BPM at 12:46:53, and a minimum rate of 51 BPM at 06:39:45.
(2) A few isolated atrial premature contractions (APCs) were noted.
(3) Episodes of short runs of sinus tachycardia were observed.
(4) No paroxysmal supraventricular tachycardia (PSVT), ventricular tachycardia (VT), ventricular fibrillation (Vf), or long pauses were found.
(5) Non-specific ST changes were noted.
(6) No diary remark episodes were recorded.
Conclusion: Sinus rhythm with episodes of APCs.

Yu, 20~29 year old female. Ask Date: 2023/11/16

Dr. Li Shengkai reply Cardiology

According to the definition, pulmonary hypertension is indicated when the pulmonary artery pressure exceeds 25 mmHg at rest or 30 mmHg during exercise.
Based on your echocardiogram report, the result was 34 mmHg, which should be monitored further.
Additionally, the report mentioned "mitral valve prolapse," which may better explain your discomfort.
It is recommended to manage stress in your daily life, maintain a regular routine, and coexist peacefully with the valve issue.

Reply Date: 2023/11/16

More Info

Based on the information provided, the estimated systolic pulmonary artery pressure (PAP) of 34 mmHg indicates mild pulmonary hypertension. According to the guidelines, pulmonary artery pressure is considered elevated when resting values exceed 25 mmHg. Therefore, a value of 34 mmHg suggests that there is a mild increase in pressure, which warrants further evaluation and monitoring.

Given your history of chest discomfort and palpitations, it is essential to consider the implications of this finding. While your heart chambers are reported to be of normal size and function, the presence of mild tricuspid regurgitation (TR) and mitral valve prolapse may contribute to your symptoms. Mitral valve prolapse can sometimes lead to palpitations and other symptoms due to the irregular heart rhythm it may cause.
In terms of monitoring, it is advisable to follow up with your healthcare provider. Regular follow-up is crucial for several reasons:
1. Progression of Pulmonary Hypertension: Mild pulmonary hypertension can progress over time. Regular echocardiograms can help track changes in pulmonary artery pressure and assess the heart's function. If the pressure increases significantly, it may require more aggressive management.

2. Symptom Management: Since you have experienced chest discomfort and palpitations, monitoring can help determine if these symptoms correlate with changes in pulmonary artery pressure or other cardiac function parameters.
3. Lifestyle Adjustments: Your recent weight gain of about 5 kg could also impact your cardiovascular health. Maintaining a healthy weight, engaging in regular physical activity, and managing stress are important for overall heart health and can help mitigate symptoms.

4. Potential for Other Conditions: While your echocardiogram shows normal left ventricular function, the presence of mild TR and mitral valve prolapse could indicate underlying issues that may need to be addressed. Regular follow-ups can help identify if these conditions worsen or lead to further complications.

5. Patient Education: Understanding your condition and its implications can empower you to make informed decisions about your health. Your healthcare provider can offer guidance on lifestyle modifications, symptom management, and when to seek immediate care.

In summary, while a systolic pulmonary artery pressure of 34 mmHg is not immediately alarming, it does warrant monitoring and follow-up. It is essential to maintain communication with your healthcare provider, especially given your history of symptoms. They may recommend periodic echocardiograms and possibly other tests to ensure that your heart remains healthy and to address any changes in your condition promptly.

Similar Q&A

Understanding Mild Pulmonary Hypertension: Diagnosis and Treatment Insights

Hello, doctor. The echocardiogram shows a TRPG of 29 mmHg, and the diagnosis is mild pulmonary hypertension. The standard value listed online is 25 mmHg. Is this considered a diagnosis of pulmonary hypertension? Is immediate treatment necessary? Will daily physical activity pose ...

Dr. Cai Guiqin reply Cardiology
I recommend that you discuss the above situation further with your attending physician to determine if any additional examinations are necessary. Thank you, and wishing you good health!

Understanding Blood Pressure and Pulmonary Artery Pressure: Key Insights

Hello, Dr. He. Due to my high blood pressure and tendency to get nervous, my blood pressure has always been elevated during military service physical examinations. As a result, I was required to wear a 24-hour blood pressure monitoring device. However, I am concerned that if my r...

Dr. He Dongjin reply Cardiology
Hello, you mentioned two issues: high blood pressure and elevated pulmonary artery pressure. In terms of military service, a 24-hour monitoring is sufficient; there is no need to perform cardiac catheterization or echocardiography solely for diagnosing hypertension, as pulmonary ...

Understanding Changes in Ultrasound Reports for Heart Conditions

I would like to ask the doctor: I have congenital aortic regurgitation with moderate backflow. This time the report shows a peak systolic pressure gradient across the tricuspid valve of 9 mmHg and an estimated pulmonary artery systolic pressure (PASP) of 14 mmHg. This is differen...

Dr. He Dongjin reply Cardiology
Hello, this is still within the normal range, so there is no need to worry. Additionally, the amount of pressure applied will not affect the interpretation. Changhua Hospital cares about you.

Understanding Pulmonary Hypertension: Diagnosis Challenges and Symptoms

I have recently been experiencing occasional shortness of breath to the point where I can't walk. Whether I'm walking or climbing stairs, I feel like I can't catch my breath, and it has become quite severe lately. However, there are times when it feels a bit better...

Dr. Huang Yinghe reply Cardiology
Hello: A cardiac ultrasound can provide a rough estimate of pulmonary artery pressure. If the ultrasound detects suspected pulmonary hypertension, hospitalization for cardiac catheterization is necessary for accurate confirmation. There are many causes of shortness of breath, and...