Hi Pamela,
The gold standard is the RHC because it is a more accurate test. The measurements are taken with instruments placed directly into the heart. The RHC will show your true results.

While an echo is a screening tool, the results can be very close to the RHC measurements or quite far off. The echo is not able to view the same places as a RHC because the sound from the transducer (probe) can not travel through bone. Instead, the echo has a mathematical equation to estimate the pressure. Several pressures are given to this equation. Each pressure is measured by the sonographer (person doing the sonogram [echo]. When the sonographer finds the measurement it is "feed" to the machine to figure out the complex equation for the estimated PH pressures.

Furthermore, a sonogram is a very operator and patient depended procedure. Some patients bodies are difficult to test. Some parts are harder to get a straight line of sound to. Lastly, every sonographer is a different person doing the exam that requires them to independently use that machine, transducer, etc. If anything is "off" in the slightest the pressures will not calculate properly. It's a difficult modality to learn and execute. X-Ray, MRI, CT, EKG, etc. are less operator dependent. The results can be more accurate. A RHC is definitely more accurate.

My advice, keep this in mind in the future. Try not to put to much weight into it. I once got an echo that showed I was fine. I knew about the operator and patient factors. I was a sonographer before my disability. So luckily I knew better and did not get my hopes up. I just got an echo that shows I am quite a bit worse than I have been in many years. I am doing my best to not worry about it and wait for the RHC results. It's tough to believe one way or the other and be let down.

I wish you all the best! Hope this helps!

Jolie Lizana

Thank you for your information.

Yes, my echos were good, my rhc showed the ph