Has anyone else gotten a dx of Pulmonary Hypertension on their TEE

I just want to say that on my 6 wk post Watchman TEE this April, there was a dx of mild to moderate pulmonary hypertension, RVSP 50-55. No doctor commented on it to me. Then when I got my 6-mo TEE this July, there was a dx of severe pulmonary hypertension, RVSP 70-75. My cardiologist saw it & had me come in to see him.

Rather than trying any little checks with a transthoracic echocardiogram (TTE) in a few months or taking some diuretic to see if there were any changes, he said the gold standard to diagnose this Pulm HTN was a right heart catheterization, so I am getting that next week. Funny thing is I don't have much in the way of symptoms, except that after I got afib and the drs started me on meds for a while in 2019, I first started feeling a tightness when I would breathe deeply. I told all the drs about it, that I could just breathe to about mid-sternum before a dry cough would pop out, stopping the breath. When the meds would be titrated down or off completely & with time after ablations, things went back to normal.

I am fit, trim & exercise a lot, nothing extreme, but just about daily classes or walks or biking. So, it seems even a bit puzzling to my cardiologist as he agreed I did not have symptoms to match severe PH.

He doubled my carvedilol (Coreg) to 12.5 mg BID since my BP was going up some (all the anxiety over this new dx & checking BPs, which I had not done in a long time). BUT, since increasing the beta blocker, I have a stronger symptom back of that same old deep breath, then cough. I know beta blocker is contraindicated in asthma sufferers, but it must be in ppl who also have some kind of COPD, like bronchitis too, because it affects me. Too bad as I just filled a 90-day supply.

I think he mentioned it would either be the carvedilol, which I tolerated well at 6.25 BID or I think he said maybe an ARB (angiotensin receptor blocking agent). I don't know anything about the latter drug category. So we stuck with my carvedilol, but doubled it. I wonder if Bystolic would have the same side effects, even though it is cardioselective. I could not tolerate the cardioselective metoprolol, so don't know about Bystolic (generic nebivolol).

Has anyone else gotten a diagnosis discovered on their TEE like this? If so, what came next for you? It is a confusing diagnosis as one can have it for many reasons or no discernible reason at all. Also, there are so many classes/levels of it. I know one thing I read sounded black & white in that it was incurable. It is a heart/lung disease. But, I wonder if one can just be diagnosed at age 74 (sounds late from what I read) & possibly not progress any more.

I would be interested to hear if anyone else has experience with this.

Wow Madeline! I had a dx of pulmonary hypertension after my covid when I couldn’t get my 02 higher than 70. There was no follow up unfortunately. My pulmonologist ignored it. I’m happy your doctor is not ignoring it.

Keep us updated.

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susan.d
Wow Madeline! I had a dx of pulmonary hypertension after my covid when I couldn’t get my 02 higher than 70. There was no follow up unfortunately. My pulmonologist ignored it. I’m happy your doctor is not ignoring it.

Keep us updated.

Hi Susan, My O2 sats are good. I was actually wondering if you had pulmonary hypertension since you treated with the ipratropium bromide (for your asthma). I don't know if using the general forum is more for posting info than asking for input.

It was ignored on the first TEE when it said mild to moderate P. HTN, but addressed when the 6-mo TEE said severe P. HTN. I will see after this coming Wednesday as the R. Ht Cath is the gold standard test for diagnosing it.

I have been trying to tell the drs about my breathing having changed since the 1st meds & then ablations for afib & flutter. I am on carvedilol & my breathing is tight feeling now that he upped my dose from 6.25 to 12.5 BID. I think I should change and perhaps try nebivolol (generic Bystolic), but if it affects me the way metoprolol did, it won't work. They are both cardioselective BBs. Then I would look into ARBs like losartan as had been suggested for me as an alternative once before, but I ended up not doing it bec not sure if it would also help my moderate benign essential tremor of hands the way the BB does. And don't tell me about propanolol (Inderal) bec I did not feel good on that when tried before. There are just so many meds that make one person feel great & another feel bad. I wish I had not let the cardiologist write the script out for #90 as I have just been on carvedilol increased dose a few wks before wanting to try something else!!! I tolerated 6.25 well, but not 12.5 & everything I read about it indicates one should not take it if any lung issues present. My BP was going up, probably also from the anxiety of this new finding of severe pulmomary hypertension.

I have been going over past research & here are some things about beta blockers:
not to use if one has any kind of COPD bec it can cause bronchospasm
one should not use them lifelong bec they can even weaken the heart to where the vessels won't respond like they used to (& here I am in 2023 after being started on them in 2018.

When my cardiologist sent me to a pulmonologist in 2019, when I complained about breathing changes again & he found mild paraseptal emphysema on an x-ray, the pulmonologist released me as I said bec I passed the test. I went back a yr later wanting to retest bec feeling funny again, but he only tested FEV1 & said nothing had changed. I told him about carvedilol contraindicated with any form of COPD, but he said even though I had mild paraseptal emphysema, ti was not obstructive, so not COPD wh of course is chronic obstructive pulmonary disease. I had never heard anyone delineate it like that, but it makes sense.

I don't know why the drs like my cardiologist negate my linking my breathing issue with the carvedilol use. I will have to talk to him about it at our visit in 3 wks, after my procedure & dx of pul. HTN, what degree I have it, or do I not have itl!! I passed the PFTs in 2019, when I was feeling weird & once they get stats from a test, they let you go as if you're fine.

I have done well on carvedilol for years even before the afib, bec I was on a low dose. Thanks for posting. Glad to see you made it back!