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Pulmonary Hypertension

When is right heart cath necessary?

01/09/2009

Question:

I have a myopathy with associated respiratory muscle weakness, hypoventilation and increased CO2 at night (all documented by testing). I have been put on a CPAP but am unable to tolerate it.

I had a MUGA scan (Multi Gated Acquisition Scan) done in 06/07 and 07/08. The most recent one showed declining RVEF (Right Ventricular Ejection Fraction). My pulmonary doctor says the CPAP is needed but because I cannot tolerate it, closer monitoring is indicated.

He said in September that a right heart catheter was not indicated at this point. I also have restrictive lung disease d/t myopathy and a decreased DLCO (Diffusing Capacity of the Lung). At what point is a right heart catheter indicated? Could this potentially turn into PH? Thanks.

Answer:

Low oxygen because of hypoventilation can lead to an increase in pulmonary artery pressures and strain on the right ventricle. A right heart catheterization is indicated to assess the pressures whenever we suspect pulmonary hypertension.

However, since the cause is obvious in your case, it would be prudent to treat the hypoventilation before measuring the pressures as they may improve with optimal use of CPAP.

For more information:

Go to the Pulmonary Hypertension health topic, where you can:

Response by:

Namita   Sood, MD, FCCP Namita Sood, MD, FCCP
Associate Professor of Pulmonary, Critical Care & Sleep
College of Medicine
The Ohio State University

Douglas W Haden, MD Douglas W Haden, MD
Assistant Professor
College of Medicine
The Ohio State University