How can you have pulmonary hypertension if your ventricles are normal?

[Flipflopper]

I am trying to understand this. I know about the 5 classes and I have mild sleep apnea, so one classing there and bilateral atrial enlargement…not sure what class that would be and mild to moderate tri and bicuspid regurgitation and aortic sclerosis ( leaflets are working normally).yet another class. I also have had paroxysmal afib for years.

But they always seem to talk about ventricle issues. I don’t have any, neither is my pulmonic valve compromised. I know my ecgs show the p wave showing bilateral enlargement, so is that why I have pulmonary hypertension?

Also… I am getting migraines after 17 years of not having them. Is that part of PHNT?

[Steve_G]

I’m not an MD but have done a little work on PH a few years back (I work in pharma). Basically it’s caused by changes in the lungs’ blood vessels through remodelling processes that change the structure of the walls making them less elastic and more rigid. This then leads to high blood pressure in these vessels because of increased resistance to the blood flowing from the heart. Blood is pumped from the right ventricle of the heart to the lungs so over time there’s a compensatory increase in the muscle of the right ventricle as it tries to overcome the increased resistance. PH is therefore associated with changes to the right ventricle.

The WHO classification of PH is based on the underlying cause however the most common type is Class 1, idiopathic PH, which basically means that the cause is unknown. There’s a lot of research going on to better understand the underlying causes and how to improve its treatment.

I’d suggest asking your Dr or GP to explain exactly what the problem is and how they’re going to treat it.

[Hidden]

Hello, my partner has PH and is now waiting for a consultation with a specialist from Sheffield which is happening on Tuesday via the phone. He was diagnosed with heart failure 12 years ago. This last year he has filled with fluid waiting for an appointment which just didn't happen due to covid and we went to the spire and he ended up with 3 CT scans and 1 MRI. He's been in hospital since the middle of May for a month then again for 3 weeks only coming out beginning of September. He's on a new drug that only consultants can prescribe and the water is staying off. He's lost over 30 kgs of water. His right side of his heart is still struggling but his left side has made some recovery. He is no were like he was pre covid and the cardiac nurse has told him that he won't be again. He's very down but getting some strength back slowly. We are both hoping that Sheffield can help make things better for him.

[Hidden]

Hi. Check out the PHA website. So helpful. This is a specialised condition needing appropriate diagnosis

[Flipflopper]

Thanks for all the input. It was greatly appreciated. I am being followed by a cardiologist who has put me onto a lung specialist as well. My cardiologist wants to wait and let the lung guy deal with the PH treatment first. I am finally semi controlled AF which gives me a better quality of life, but just not sure why I have PH. ORwhy my left ATRIUM is severely dilated and right is just dilated. No one wants to talk about that yet. 6 years ago I had. Complelty normal heart…other than a fib. No leaky anything..no dilated atrium. Just trying to figure out things. I have stuff that could be a few different classes. A fib, sleep apnea, bi and tricuspid regurgitation moderate, aortic sclerosis mild. But I just thought it would show in my ventricle? It is like my left atrial is suffering not the ventricles and that doesn’t make sense.

No one has ever attributed left heart disease with the severely dilated left atrium either, so it’s a bit confusing to me. Do I, don’t I? I had good results on a stress echo and literally convinced myself I didn’t have PHNT. My cardiologist set me straight. He said the a fib is possibly like a canary in a coal mine… I’ve had a fib for many years now..almost 20 actually, so if that is the case, again, why do I have normal ventricles… kind of like a puppy chasing it’s tail. Ha ha!

[Flipflopper]

Thanks! I am an old medical office assistant, so love reading medical papers. Working for specialists also unfortunately makes me want to dig deeper than the average bear 😀

[Hidden]

Thank you. I will sit and read that today. Sorry not replied sooner my mum is poorly too and I need to be in 2 places at the time 🤣