Brief Answer:
I would explain as follows:

Detailed Answer:

Hi,

Your cardiac ultrasound doesn't support any clear diagnosis of pulmonary hypertension.

First of all, the primary criteria for diagnosing pulmonary hypertension would be an increased mean pulmonary artery pressure of equal of greater than 25mm Hg.

On your echo report there is no evidence of increased pulmonary artery pressure.

It is described a trace/mild tricuspid valve regurgitation (which is commonly found in normal individuals), but there is no prescription of any increased TR velocity. So, there is no conclusion on the presence pulmonary hypertension.

In addition, there is no evidence on the presence of other elements supporting the diagnosis of pulmonary hypertension such as: an enlarged right ventricle and atrial dimenssion, there is no flattening of interventricular septum; there is no dilated inferior vena cava dimensions and/or any abnormality of its respiratory collapsability.

Also, there is no abnormality on pulmonary valve systolic flow (such as decreased acceleration time, or a notched pulmonary spectral pattern).

To conclude, I would explain that the only abnormality seen on your echo report is reduced right ventricular ejection fraction (EF), which may be caused by several possible causes.

Coming to this point, I would recommend discussing with your attending physician on the possibility of further diagnostic tests such as: cardiac MRI, pulmonary function tests, ventilation perfusion lung CT scan, etc..

The performance of further tests would be better guided by the clinical symptomatology.

Hope to have clarified some of your uncertainties! I remain at your disposal for any further tests whenever you need!
Regards,
Dr. Iliri

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Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again!

Regarding your concern I would explain that right ventricular ejection fraction may be decreased in disorders affecting the left heart. In general, right heart dysfunction seems to be a late finding of in the chronic clinical course of a left cardiomyopathy.

Other causes of RV dysfunction may derive from any pulmonary disorders (acute or chronic) such as pulmonary thromboembolism, chronic respiratory disorders like chronic obstructive pulmonary disease, bronchial asthma, pulmonary fibrosis, etc.

In addition, certain in situ right ventricular disorders, like right ventricular cardiomyopathy (ARV - arhythmogenic right ventricular cardiomyopathy, right ventricular non-compaction, etc. right ventricular ischemia or infarction, severe chronic triculpid valve dysfunction, etc.

In fact, during the above mentioned pathological processes involving right ventricle, some degree of RV dilatation is almost always present. But, in your case, we don't have evidence of RV dilatation, and no important tricuspid valve regurgitation.

Coming to this point, I recommend discussing with your doctor on the possibility of repeating again a careful cardiac echo, just to be sure that a decreased RV ejection fraction is really present and then to proceed to other medical tests I mentioned at the beginning of our thread.

In case of any further questions, do not hesitate to ask me again.

Kind regards,

Dr. Iliri

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