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My RVSP by echo is 36, but I’ve been experiencing significant symptoms including progressive shortness of breath, dizziness, and chest pain. My EKGs show right axis deviation, and I’ve also tested positive for a scleroderma antibody and have certain features (Raynaud’s, etc.), though haven’t been diagnosed with it formally, as my rheumatologist said I don’t meet the criteria. Has anyone managed to get a RHC under circumstances like these?
For my husband, he got the RHC due to the PAH specialist could not treated him before she verified that he in fact had Pulmonary Arterial Hypertension
The test that verifies that you have PAH is a RHC. So I would try to contact a PH specialist who would know how to figure out what group of PH you have. There are 5 groups and only group 1 goes by right side heart failure. The other 4 groups go by left sided heart failure.
Some insurance companies will not cover the RHC unless your systolic reading on your echo is at least 40. My own general cardiologist usually uses 40 as his benchmark as well...though sometimes if the person is very symptomatic and has related comorbidities, he'll write a letter of medical necessity to get it approved.
Debra's suggestion of getting a full cardiac workup would be a good idea. and if you get another echo, try to get one with contrast media for better views of the heart functions. While no echo will confirm a diagnosis of PH, the contrast echos give a more complete story.
You should see a cardiologist for a workup. PH diagnosis isn't one size fits all. Echos are very helpful but not the final determination. Right heart cath is the gold standard to rule PH in or out. There's also several tests(labs, stress tests) he also uses for diagnosis .
How can someone request a right heart catheterization (RHC) with an RVsP of 36?
While current guidelines typically recommend further evaluation for RVsP greater than 40 mm Hg, the threshold isn't absolute. Some people with RVsP lower than 40 mm Hg may benefit from further evaluation based on their individual situation.
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