Is pulmonary htn usualy get worst by time? and what's the causes? 42,57mmhg i'm19 iheared that echo is not accurate for pulmonary htn, is it true?

Depends: Pulmonary hypertension may have no known cause(idiopathic) or may be secondary to heart or other lung pathology. It can be stable or it can worsen. Echocardiography gives a rough idea of the degree of pulmonary hypertension, but right sided cardiac catheterization gives an accurate reading. A cardiologist or pulmonologist should assess, diagnose and,if needed, treat and follow-up your problem.