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Risk of PULMONARY HYPERTENSION with PVC'S in ECHO.

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This question is for pulMologist!hope you are well! My mom is a px of Stanford Hospital in Palo Alto, Ca. For past 10 yrs. she was born with congenital hole which was repaired in 1975 in Queen's hospital in England. She is currently almost 78 now. She has a hx of PVCs for which she goes in for Echo and Holter monitor yearly. Her last echo was 07/07/15. It showed normal left side of heart but increase pressure right side with slight inc in heart damage from previous echo one yr. the pressure last yr was 25 now is 41. I am very concern about her Dx of possible pulmonary hypertension Her previous cardiologist moved to Texas about 2 yrs ago . However, during the visit he would pull the echo and review everything with us. How reliable is echo ? Can different techs get different findings? Since this is a hospital setting can the echo be misinterpreted ? How serious is her condition? She has no swellingin her ankles, no dizziness , no shortness of breath. She does cough but she always did. Not more than normal. Please advice!


Category: Pulmonologist

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Category: Allergy and Immunologist
Dr. Jacob George Pulinilkunnathil is online now

Expert:  Dr. Jacob George Pulinilkunnathil replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
Regards from our side.
The gold standard for diagnosing pulmonary hypertension is right heart catheterization and not echo.echo can both over estimate and under estimate right heart pressures.

Does your mother have any lung condition /lung diseases? Does she snore? I wouldn't worry as long as she has no shortness of breath or desaturation.

Would I ask for a repeat echo? No is my answer as long as she is symptomatic.
Suggest saturation monitoring and an arterial blood gas if possible.

Regards
Dr. Jacob George P
MD, IDCCM, FCCP


Patient replied :

Thank You! My mom does snore . I was concern about sleep apnea. She has no lung conditions ie asthma, copd, etc.
If she has sleep apnea, can with tx reverse any pulmonary htn? Thanks


Expert:  Dr. Jacob George Pulinilkunnathil replied 3 Days.

Dear friend,
Regards from our side once again.
We need to have a sleep study for confirming / refuting a diagnosis of sleep apnoea.
If she had sleep apnoea, then it's treatment will reverse pulmonary hypertension.


Dr. Jacob George Pulinilkunnathil
Category: Allergy and Immunologist
Experience: 
Residency, Post Graduation: MD, Respiratory Medicine, J L N Medical College, Ajmer, Rajasthan (2012).
Medical School, Internship: MBBS, Government Medical College, Kottayam, 2001-07 
Indian Diploma in Critical Care Medicine (IDCCM) - Medical Trust Hospital, 2013-2014.
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