• 1.Can echo diagnosis be wrong?
• 2.Does PH as opposed to PPH have better prognosis/life expectancy?
• 3.Explain cardiac output measurements.
• 4.My echo shows pressures of 50, but the right heart cath showed normal. Could I still have PH?
• 5.I was just diagnosed and am scared. How long do I have to live?
• 6.If I have SPH, should I still see a PH specialist?
• 7.Could I have PPH which is mistakenly diagnosed as asthma?
• 8.Does PH run in families?
• 9.Is my doctor right when he tells me I would get better if I lost weight?
• 10.My echo shows pressures of 50-60, but the doctor says I do not have PH, can they be wrong?
• 11.Why is it important for me to see a PH specialist?
• 12.What causes PH?
• 13.What is the difference between mean PA pressure and PA pressures measured by an echo?
• 14.What is the mean pulmonary artery pressure and how do you get the number?
• 15.What is the life expectancy with PH?
• 16.What tests are done to determine PH?
• 17.What tests are done to determine PPH over SPH?
• 18.When should I start treatment if I have been diagnosed with mild PH?
• 19.Where can I find a PH specialist in my city or state?
• 20.Why do I have chest pains with PPH?
• 21.My doctor is either a cardiologist or a pulmonologist. Why do I need to see a specialist?
• 22.What medications are most commonly used for treatment?

Can echo diagnosis be wrong?

Yes. The echo estimates the pulmonary artery pressure, and can either underestimate or overestimate the true pressure. The gold standard is the right heart catheterization. However when echos are done carefully by experience echo cardiographers the pressures estimated by echo usually correlate fairly closely to those obtained during cardiac catheterization. Echos can also provide some additional useful information regarding size and function of the right ventricle, severity of leakage of the tricuspid valve, and extent of distension of the inferior vena cava (large vein in the abdomen that returns blood to the heart).

Does Idiopathic Pulmonary Arterial Hypertension (IPAH) as opposed to PAH associated with other diseases (APAH) have better prognosis/life expectancy?

The prognosis in APAH depends on the specific cause and the severity. Some studies suggest that APAH due to collagen vascular diseases like scleroderma has a worse prognosis than IPAH, but this depends on severity when it is detected. PAH due to congenital heart disease tends to have a better prognosis than idiopathic IPAH. Portopulmonary hypertension and HIV-related PAH have prognoses similar to that of idiopathic. Although not technically an “associated” PAH because it is classified in a different group, PH due to chronic pulmonary embolism (blood clots in the lungs), known as Chronic Thromboembolic PH (CTEPH) has an excellent prognosis when the clots can be removed surgically.

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