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Forum Name: Cardiology Diagnostics

Question: Pulmonary Hypertension


 qwert - Thu Apr 26, 2007 5:23 pm

My father (71) just went to see his cardiologist after having extreme fatigue. He's doctor did an EKG, which he said was normal; however, he estimated his pulmonary artery pressure to be 68 mmHg. All the literature I can find on the internet says that the normal range is around 20...with 70 mmHg, an average starting pressure for heart attacks/failure. His doctor has ordered a sleep test for a month from now, suspecting that sleep apnea is the cause of what he thinks is pulmonary hypertension. Can he wait this long if his pressure is so high? And, how accurate is an EKG at estimating pulmonary artery pressure? And, finally, can you really diagose someone with pulmonary hypertension with simply an EKG?

Any help would be greatly apprecited!(really worried).

Thanks,
concerned daugther
 Marceline F, RN - Fri Apr 27, 2007 1:37 am

User avatar Dear qwert,
I respect you for doing your research into your father's clinical condition. An EKG is an electrocardiogram - which is by definition the tracing of electrical activity across the heart. There has been established over decades what would constitute a normal tracing - with certain allowable variables in the parameters for "normal". With that in mind, one could see, to some degree, certain anatomical abnormalities such as hypertrophy or cardiomegaly. Based on ones knowledge of the clinical concurrencies of these abnormalities, one could certainly suppose certain probabilities such as pulmonary hypertension related to Right sided heart failure, especially if your father also has COPD or other pulmonary complications. To use an EKG alone for determining the degree of hypertension seems unlikely. Did the cardiologist also do an echocardiogram? This could account for his diagnosis, since it would show some of the clinical contributing factors for pulmonary hypertension.

Is your father short of breath, as well as fatigued? Have they done other tests to rule our pulmonary emboli? (Such as VQ scan or Chest Cat Scan done specifically to rule in/rule out PE). PE can be very serious, but has readily available treatment options.

The only way I am aware of to get a definite diagnosis of pulmonary hypertension and to ascribe a value of the pressures associated therewith, is to do a heart catheterization or other internal heart pressure monitoring (such as a SWAN that may be placed post surgery to closely monitor cardiac pressures in an intensive care unit. I suggest you consider taking your father to the local emergency room if he is still symtomatic, and let the ER physician evaluate him for pulmonary emboli, as well as being able to run lab tests to see if his chemistry is within normal limits, or even his CBC (complete blood count) to see if he is anemic. There are so many reasons why one might be fatigued. Since you are obviously concerned and think there is possibly something other than sleep apnea at work here, please explore other possibilities.

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