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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 52493
Experience:  Cardiology Expert
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Is there a cardiologist available?

Customer Question

Hello is there a cardiologist available?
Submitted: 1 year ago.
Category: Cardiology
Expert:  Dr. Phil, MD replied 1 year ago.

Im here

Customer: replied 1 year ago.

HI, I believe we chatted before but I had another echo done and wanted to know your opinion.

So I have had three echos in the past year (I guess to see what is going on.) I am mainly concerned with IPAH. The first echo I had done my RVSP pressure was 35, second was 30 and my most recent was 32. I am worried since it seems like those are my numbers and there isn't a chance of missreading. Is this concerning?

Expert:  Dr. Phil, MD replied 1 year ago.

Reading an echo is an art not a science. So I would trust those readings.

It is highly dependent on the tech and the reader.

A variation in 5 is not uncommon

Customer: replied 1 year ago.

I understand that but I am worried about mild PH and slowly progressing over time to something worrisome.

Expert:  Dr. Phil, MD replied 1 year ago.

How could it be progressing if the echo was better?

Customer: replied 1 year ago.

Not progressing at this point but it seems that my pressures are elevated for my age which are 33. They should not be in this range. I am worried that over time it will progress. Like at 40 I will have a RVSP of 38, at 45, RVSP of 45 and then I progress to IPAH

Expert:  Dr. Phil, MD replied 1 year ago.

I think you are worrying unnecessarily. That is like worrying that your blood pressure is going to go up.

This is all in your mind. There is nothing to say that this will get worse with time. Just eat healthy and exercise.

You will be fine

Customer: replied 1 year ago.

Okay....well isn't it true my chances of getting IPAH in the future are higher then someone my age whose RVSP pressures are in the 20s?

Expert:  Dr. Phil, MD replied 1 year ago.

No I don't agree with that. You might just have a higher RVSP

Customer: replied 1 year ago.

I understand doctor, but I am looking more for facts. Yes there might be a chance I just have a higher RVSP....but I believe it is still better to start off with lower RVSPs, especially since at my age this number is ***** high.

So what you are trying to say is someone at 33 with an RVSP pressure of 35 has the same exact chance of getting IPAH in the future as someone 33 who has a pressure of 22??

If that is the case, why would the doctor want to me to come back for a repeat echo in a year? When someone who has a RVSP pressure of 22 he would say no follow up necessary.

Expert:  Dr. Phil, MD replied 1 year ago.

I see patients with the same RVSP for years and years

Customer: replied 1 year ago.

Dr. I don't know why it is difficult to communicate with you, but you are not answering my question. I don't know why it seems as if you are deliberately trying to avoid answering it.

Customer: replied 1 year ago.

I would really appreciate it if you would answer my question

Expert:  Dr. Phil, MD replied 1 year ago.

I am guessing it is because you present with anxiety.

He is probably trying to reassure you by doing an echo in another year

Customer: replied 1 year ago.

I am sorry but that is not the question. I would like this one answered.

So what you are trying to say is someone at 33 with an RVSP pressure of 35 has the same exact chance of getting IPAH in the future as someone 33 who has a pressure of 22??

Expert:  Dr. Phil, MD replied 1 year ago.

Yes, that is what I am saying

Expert:  Dr. Phil, MD replied 1 year ago.

Please don't forget a positive rating. I appreciate it. :)

If you have more questions, just reply

Customer: replied 1 year ago.

Ok, so can you give me a chance in percentage that I will develop IPAH in the future/

Expert:  Dr. Phil, MD replied 1 year ago.

5-10%

Customer: replied 1 year ago.
Last time I asked you this same question you answered between 2 and 5 percent. Would
You have given the same answer of my RVSP was 22?
Expert:  Dr. Phil, MD replied 1 year ago.

This is just an estimate on my part. 2-5% is just as easily likely. You are asking a question to which there is no clinical data to help me. It is a guess.

Customer: replied 1 year ago.
okay and you would have given this same exact estimate to someone who has an RVSP of 20?
Expert:  Dr. Phil, MD replied 1 year ago.

Yes, because both are "normal"

Customer: replied 1 year ago.
you are saying the average person has a 5-10 percent chance of developing IPAH in the future?
Expert:  Dr. Phil, MD replied 1 year ago.

over their lifetime? Yes roughly

Expert:  Dr. Phil, MD replied 1 year ago.

Well, at least that is what I see in my practice. But then again my population may be skewed because they are "heart" patients

Customer: replied 1 year ago.
Okay you know I am getting really frustrated with your answers I feel like I have to cross examine you and you are not giving straight answers, which I honestly don't know the reason. Either you are not a cardiologist or you simply don't know the answers
Expert:  Dr. Phil, MD replied 1 year ago.

I think the issue is that you are not happy with my response and are trying to get me to agree with you. I see absolutely no difference that your RVSP is 32 compared with 22. They are both normal. High normal carries no relevance. You are saying that if my white blood count is 10 compared to 4 then I am more likely to develop leukemia because my white count is higher. No. That is not how it works. You are normal and that is all that matters. Your anxiety is getting the best of you.

Expert:  Dr. Phil, MD replied 1 year ago.

Look up what the risk of IPAH is in the general population and that is your risk. You don't need to ask my what I think about it. Your risk is the same as average joe on the street. I am not evading you. You are asking the same thing over and over again and expecting a different answer

Expert:  Dr. Phil, MD replied 1 year ago.

Please don't forget a positive rating. I appreciate it. :)

If you have more questions, just reply

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