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What Causes Elevated Pulmonary Artery Pressure?

Posted on Wed, 19 Apr 2017

Question: Age:49, Gender: Female

Hello...I'm currently 49 years old and healthy. Back in 2005, about twelve years ago, I had some chest pressure and was sent for a stress test. The test came back normal, but did show elevated pulmonary pressure of 41 at rest. Subsequent echocardiograms showed pressure at 36 and 41.

I visited a pulmonologist back in 2005, and had a sleep study, and a ventilation perfusion scan. The only thing that showed was bronchiectstasis in my lungs.

The most recent test I had was an EKG in 2013, which was normal. I walk three miles every day, have no shortness of breath, chest pain, swelling, fluid retention, finger clubbing, etc.

Nothing has been addressed with my primary care doctor (a different one since this happened back in 2005). Do you think I have anything to worry about or should be having anything checked out?

Answered by Dr. Rishu Saxena (1 hour later)

Brief Answer:
seems normal.

Detailed Answer:
Hello,
Thanks for Posting query on this platform.
I am Dr. Rishu Saxena, Cardiologist and will be answering your query.

Pulmonary pressure around 35mm of hg is normal. Your Pulmonary pressure in 2005 was in between 36 to 41 mmm of hg.Practically speaking its just mildly elevated Pulmonary pressure better can be termed as a bit higher to normal.

A health patient walking 3 miles a day with no discomfort, I truely don't feel there is any need to worry even in the least at present.

However I would suggest you to go for a 2D-Echo every 6th month to see changes of Pulmonay wedge pressures. More then 45mm of hg is usually symptomatic.

As of now no need to worry, you are fine.

Suggestion-
Repeat 2D echo every 6 months.

Thanks and Feel free to ask query.

Regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Rishu Saxena (1 hour later)

Hi Doctor! Thanks so very much for your quick and reassuring answer!!

I'll definitely speak with my doctor about having another echo done.

Would you say that if there had been damage occurring to my heart over the past twelve years, I'd be experiencing symptoms by now, shortness of breath, chest pain, etc...I have none of that! And also, would you say that the ekg which I had three years ago probably would have shown some right sided chamber enlargement?

Finally, I remember that I had been using pseudoephedrine daily back in 2005 for sinus congestion and issues and the pulmonologist mentioned that could have caused the increased pressure....is that a possibility?

Thanks again immensely for your help!!!

Answered by Dr. Rishu Saxena (7 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
Yes a patient with pulmonary hypertension can't remain asymptomatic for 10 years and yes right ventricular hypertrophy would have be reflected in ecg.Ihf right ventricle is pumping blood against raised pressures there has to be some hypertrophy in 10 years.

Pseudoephedrine causing elevated pulmonary artery pressure is possible yet I would term this as over diagnosis.
In Developing countries pseudoephedrine is used almost in every patient with cough cold and coryza(due to cost issues). So I don't think short term therapy has any thing to do with elevated pulmonary pressures.

Suggestions-
Repeat a 2d echo ask the technician to provide video of recordings captured and mail it to me otherwise ask you attendant to capture video on a smart phone.

Thanks

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Above answer was peer-reviewed by : Dr. Yogesh D