Pulmonary Hypertension and Morbid obesity

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Submitted by Dr T on February 4, 2011 – 9:54am

Question: 
Follow up (Pulmonary Hypertension is it dangerous?):
I dont know any more specifics from this echo because he only ordered it to show the rsvp and not a full echo. The number was all he told me. I actually had been feeling better and able to exercise more. I have never had the shortness of breath but had 9 months ago had episodes of feeling like I was gonna pass out. That is why the first echo was done. I had a prior echo done 10 years ago when I would have been 36 and it was ok. Since that time I have gained 100 pounds. He feels this is the cause. I have had ANA tests which came back negative and a sleep apnea screening at home which was ok. He is sending me to have a full sleep study. I have been to lung doctor and had chest xray with no cause there and my oxygen level remains 97-98%. I am very concerned about waiting. The family doctor wants to do another echo at another place in 3 months but the cardiologist who I have seen for 210 or so years wants to wait 6 months. I have lost 5 pounds and will try hard to lose weight. Will my pressure being 57 cause major damage if I wait three months? I have no idea what n umber is the dangerous number. I know the worrying about it cant be good. Should I seek a second opinion from another cardiologist? Have the echo sooner or wait the 3 or 6 months? My weight is 285 and I am 5’7.

Your doctors are probably correct in correlating your weight with PH, even though it is not a specific risk for PH, because with a BMI= 44.6 you are considered morbidly obese.
At age 46, you are at a high risk for all sorts of major life threatening complications, of which PH is only one. Have you considered a gastric bypass procedure? I am concerned that traditional weight loss programs may take too long or are impossible to achieve a weight loss of about 100 lbs in the kind of time frame to help with your PH:
I blogged about this before:
https://www.cardiachealth.org/ca-blog/i-had-an-echocardiogram-that-show
https://www.cardiachealth.org/heart-information/obesity
As far as the timing of your next ECHO is concerned, I’d favor one sooner rather than later, particularly because the cause has not yet been determined, and for that you probably will need more invasive tests such as a “right heart catherization.
Hope this helps,
Dr T
https://www.cardiachealth.org/

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