When does a doctor normally begin treating a pulmonary hypertension diagnosis?

[curious74432]

In 2018 I had an echocardiogram and the doctor said that the pressure in my lungs was mildly elevated. My cardiologist received the information from the other doctor and advised that I had mild pulmonary hypertension. In 2019 I saw him and no echo or anything was done. No one prescribed medication or advised anything I should do. I had another echo recently but do not know the results yet. When does a doctor normally prescribe medication or have you do anything regarding pulmonary hypertension? When I had the first echo,
Normal left ventricular size and systolic function (EF 60-65).
Normal right ventricular size and systolic function (TAPSE 20-21 mm).
No hemodynamically significant valve dysfunction.
Estimated RV systolic pressure is elevated (40-45 mmHg).
Your heart is pumping good. The pressures in your lungs are mildly elevated.
I am just wondering as I have been having more shortness of breath and fatigue in the past year or so. Thanks for any insight on this.

[ayl291]

You need a right heart cath to confirm it.  Echo is a preliminary test.  

[2210485]

This too. I s’pose it could be a bit worse when you look at invasive pressures.

Would you hold the RHC until screening for CAD?

[ayl291]

No, in my opinion if you do excerise with rhc than your pressures will most certainly be clarifying and simultaneously you would be able to look at how well you heart can utalize o2 and other parameters that could indicate cad ( ekg testing).

But if you prefer to first go for a coronary angio ( could be via ct) thats reasonable too.

Regardless though, with suspected pah and dyspnea I would personaly do a rhc to know if it has any relationship.

[2210485]

I’m not an echo guy but this showed up in my feed; so I’ll give my not-so-helpful opinion.

I think that it’s likely that pulmonary hypertension would be treated when there’s an impact on your RV function or complications involving your pulmonic valve.

I would say that in light of your progressing symptoms that they’d probably want to investigate other causes of your shortness of breath before just treating your for PHTN and sending you on your way.

Have you had any stress testing or cardiac catheterizations?