I have Systemic Sclerosis (10 odd years). Had echo in Sept due to palpitations/pain in left side of chest. Showed mild RAE and Moderate LAE and my RV was upper limits of normal. Have been on amlodipine and quinapril for about 6-7 years as well as other meds. My blood tests came back fine except for my RDW which is elevated. My NT-ProBNP was only at 6 pmol/L so very low. The Cardiologist immediately ruled out coronary disease - he said I was too young (40yrs old). Said it could be Atypical Angina that was causing the chest pain but no way to test accurately due to my age and said he he could not tell me it wasn't PAH. He said the test for PAH was quite invasive and would be better off to request another echo in 5 years. He also said that I don't look like a typical SSc patient, that my disease is well managed and that the methotrexate should keep me from getting PAH. My ECG (72 hr holter) just showed PVCs and Sinus Tachycardia - nothing he was worried about. I asked him about my RDW being elevated and he said he didn't know what that was. I said Red Cell Distribution Width and he still didn't register. That made my a bit skeptical. I want to know if taking amlodipine in conjunction with quinapril for a number of years, for reasons other than heart problems, would basically nullify the value of the NT-ProBNP test and whether there could still be something going on. He said to get more exercise and that he didn't think he would need to see me again. All well and good if all the assumptions are correct. BTW, my blood sugar levels are low, I am a little curvy but not obese on the BMI chart and get a fair bit of physical activity with my job.