left ventricular filling pressure

[rje11]

I had a heart cath done this past week and was told two things.  1) I have CAD with blockage on the right coronary artery but it was not enough to stent, thankfully.   2)  The left ventricular filling pressure was more than twice what it should be (the number was .26 or thereabouts).  My cardiologist said this means we need to be extra diligent about getting my blood pressure down. (Already on Coreg 40 mg, Losartan 50mg 2 x day, Adalat 30 mg, and Lisinopril 10 mg.  Can't take diuretics as they cause electrolyte imbalances quickly).

I was given Ranexa for angina and told to increase my Adalat to 60 mg, but the increase causes my bp to drop too low during the night (80's and 90's over 50's and 60's) and I struggle to keep from passing out if I go to the bathroom.  Angina has returned today (on Ranexa for three days).  

How serious is the elevated LVFP?  And what is the top of the scale on the measurement of that?

I am a 52 year old female, diabetic, hypothyroid, overweight by about 30 lbs or so.  

Thanks for your input!
Ramona

[CCFCardio MD2]

A normal LV filling pressure is less than 18 typically.  26, if it is truly measuring the left ventricular end diastolic pressure, is a bit high.  Treatment for this would be blood pressure control and diuretics.  The main question is WHY your LVEDP is high, perhaps because you have a stiff heart due to your high blood pressure.  I would work with your doctor to try a diuretic with careful monitoring of your electrolytes.  You should also be diligent about minimizing your sodium and fluid intake.  Hope this helps!

[rje11]

Thank you for this information.  It is very helpful.  May I ask a couple of follow up questions:

1) Is there a difference between the LV Filling Pressure measurement and the LVEDP measurement?  I have been reading on the function of the heart and trying to understand the difference between the two, but I have not quite grasped it yet.  If my LVFP was .26, does that mean that my LVEDP is the same?  

I have had blood pressure for many years that has been difficult to control, and was told at one point that I have left ventricle hypertrophy, so I suspect this is the  cause of the high pressure.

2)  I do limit my sodium intake, but I have NOT been limiting my fluid intake.  As a matter of fact, I have been trying to drink as much water as possible, as I thought that was the healthy thing to do!  In this case it may not be, though?  I have noticed the last few days that I do not seem to be eliminating nearly the amount of water that I take in...  

Thanks again for your help!
rje