36 years! I had been seeing my oncologist every six months except for more frequently when I developed MGUS (pre-Multiple Myeloma) from a Covid booster. But that’s in remission now too. I just saw the oncologist this week and have been promoted to annual visits going forward.

I turn 75 this September. That’s a big deal having once been told I would not live to see my 40th birthday.

Most people have no issues during or following an RHC. If your doctor recommends it and your insurance will cover it, I recommend your doing it. I have been fully awake during all 4 of mine and I can be a bit of a wimp. I had no issues other than my back hurting due to lying flat for so long. And the doctor would give me increase pain relief due to the back so the discomfort was momentary.

Heather, thank you for your thorough reply. I appreciate you taking the time to explain everything. I’ve been doing a lot research this last year and am aware of most of what you mentioned.

As of March 2, 2025…
“The World Symposium on Pulmonary Hypertension recently redefined PH as a mean pulmonary arterial pressure >20 mm Hg, based on a wealth of epidemiologic evidence underscoring the significant impact of even mildly elevated mean pul-
monary artery pressures on major adverse clinical events. The lowered diagnostic threshold for PH has re-newed interest in echocardiography and its critical role in early detection and screening…”

When I saw this new lower threshold and their reasons for changing it, I started to worry. But I realize a RHC is necessary for a definite diagnoses and an echo is only an estimate. I really hope my echo pressure results are not accurate and are actually lower.

I have lupus, a connective tissue disease, so if I do develop PH it will be category 1 PAH. AI says Pulmonary arterial hypertension (PAH) affects 9% of people with lupus but I’ve seen studies that estimate up to 29% will develop SLE-PAH.

In addition to the echos I had Pulmonary Function tests and a lung/heart CT scan.

My Risk factors (per REVEAL PAH risk calculator) are connective tissue disease, BNP level more than 100 ng/L last four years and renal disease stage 3b (eGFR<60 mL-min). I have Raynaud’s phenomenon and anti-phospholipid syndrome which have also been shown to increase risk for developing PAH.

My second echocardiogram was done by a PH specialist in Santa Barbara, CA, and the results said my RVSP was 32 and mPAP was 21 mmHg. On my first echo, done with my local cardiologist, the results showed a RVSP of 30 and I used the formula mPAP = .61 x RVSP + 2 to get a mPAP of 20 mmHg.

I understand a RHC provides more reliable results and the specialist said I need a RHC to get a definite diagnoses but I really don’t want to get this invasive procedure. I’ve read about people getting blood clots and other things. Everything about it sounds awful.

just wow! 🙂

And one more copy and paste for good measure: In echocardiography (echo) reports, systolic function is typically assessed by measuring the ejection fraction (EF), which represents the percentage of blood pumped out of the left ventricle with each beat. Additionally, systolic function can be evaluated through other measurements like global longitudinal strain (GLS) and fractional area change (FAC). Mean arterial pressure is not directly assessed in echocardiography but can be estimated from other measurements like pulmonary artery systolic pressure (PASP).