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Heart Disease (Expert Forum)
Re: A few questions please
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Re: A few questions please
by Kelleyd, Jan 31, 2004 12:00AM
I am a 34 yowf with obesity. 2 years ago suffered a "panic attack" but I asked my PCP to exhaust every avenue of my heart because I got very scared. EKG's have all been normal. Bloodwork taken at the ER various times- Normal. Heart monitor showed I had some PVC(?) but those are normal/benign he said. Echocardiogram-I have ?? about- The conclusion is: Normal left venricular function with minor mitral andd tricuspid regurgitation. No other structural heart disease identified. Estimated right heart pressures are borderline elevated. Measurements show IVS 0.7 (nl 3.5-5.6cm), LVD 4.9 (nl 2.5-5.4cm), LVS 1.9 (nl .6-1.1cm), LVPW .6 (nl .6-1.1cm), Fractional Shortening 60.9 (nl 21-57%), LA 3.9 (nl 1.6-4.0cm) then out from that is 2D 4.5 x 3.1., AO 3.0 (nl 2.0-3.7cm), AVE 1.9 (nl 1.5cm) RV 2.5.
Under interpreation everything said normal other than what mentioned in Conclusion except "mild age changes to aortic and mitral valve", okay now my ?? are: What do the measurements mean, especially the ones that seem out of normal range? Would being extremely nervous/scared during ECHO effect results? What are PVC's, why do I feel them? Sometimes if I feel my pulse in my neck it's as if I feel a slight "delay" is that nl? I am currently on Atkins losing weight, walking, yesterday BP was 116/75 with meds (toprol XL 50 qd, Micardis HCTZ 80/12.5 qd). Does this sound like a normal heart to you? It doesn't take much to get it going with exercise but I am (WAS) over 150 lbs overweight, now only 125 so I'm sure that has a lot to do with it. I try and keep pulse in 140's when exercising
Under interpreation everything said normal other than what mentioned in Conclusion except "mild age changes to aortic and mitral valve", okay now my ?? are: What do the measurements mean, especially the ones that seem out of normal range? Would being extremely nervous/scared during ECHO effect results? What are PVC's, why do I feel them? Sometimes if I feel my pulse in my neck it's as if I feel a slight "delay" is that nl? I am currently on Atkins losing weight, walking, yesterday BP was 116/75 with meds (toprol XL 50 qd, Micardis HCTZ 80/12.5 qd). Does this sound like a normal heart to you? It doesn't take much to get it going with exercise but I am (WAS) over 150 lbs overweight, now only 125 so I'm sure that has a lot to do with it. I try and keep pulse in 140's when exercising
Doctor's Answer
by CCF-M.D.-RCJ, Jan 31, 2004 12:00AM
Kelleyd,
Thanks for the post.
Q1:"What do the measurements mean, especially the ones that seem out of normal range?"
The only measurement that is significantly "out of range" is the LVS, or left ventricualr septum. This thickness could be from obesity, hypertension, or hypertrophic cardiomyopathy. The only way to distinguishe would be for you to lose weight, and see if the septum decreases in size.
Q2:"Would being extremely nervous/scared during ECHO effect results? "
Possibly, but mostly by increasing the heart rate and making the heart appear to beat very vigorously.
Q3:"What are PVC's, why do I feel them? Sometimes if I feel my pulse in my neck it's as if I feel a slight "delay" is that nl?"
PVCs are Premature Ventricular Contractions, which means beats that originate in the lower chambers of the heart and are premature.
Some people feel PVCs, some people don't, some people feel them only some of the time, and some people them feel them all of the time.
I'm not sure what you mean by the delay in your neck. If I'm understanding you correctly, this could be from the PVCs.
Q4:"Does this sound like a normal heart to you?"
The echo and ecg are consistent with the heart of someone with obesity. Many overweight people will have an enlargement of the heart, presumably from the strain of having to supply blood to the excess tissue. The good news is that the heart tends to revert back to its previous size if the person loses weight. The bad news is that heart failure can develop in some people if the weight does not come off.
Congratulations on your 25# weight loss! This is a great start. Keep up the good work.
Thanks for the post.
Q1:"What do the measurements mean, especially the ones that seem out of normal range?"
The only measurement that is significantly "out of range" is the LVS, or left ventricualr septum. This thickness could be from obesity, hypertension, or hypertrophic cardiomyopathy. The only way to distinguishe would be for you to lose weight, and see if the septum decreases in size.
Q2:"Would being extremely nervous/scared during ECHO effect results? "
Possibly, but mostly by increasing the heart rate and making the heart appear to beat very vigorously.
Q3:"What are PVC's, why do I feel them? Sometimes if I feel my pulse in my neck it's as if I feel a slight "delay" is that nl?"
PVCs are Premature Ventricular Contractions, which means beats that originate in the lower chambers of the heart and are premature.
Some people feel PVCs, some people don't, some people feel them only some of the time, and some people them feel them all of the time.
I'm not sure what you mean by the delay in your neck. If I'm understanding you correctly, this could be from the PVCs.
Q4:"Does this sound like a normal heart to you?"
The echo and ecg are consistent with the heart of someone with obesity. Many overweight people will have an enlargement of the heart, presumably from the strain of having to supply blood to the excess tissue. The good news is that the heart tends to revert back to its previous size if the person loses weight. The bad news is that heart failure can develop in some people if the weight does not come off.
Congratulations on your 25# weight loss! This is a great start. Keep up the good work.
PVCs are premature ventricular contractions. The impulse originates in the ventricle and come early in the cardiac cycle. Then there will be a bit of a pause until the next beat. This is what you feel. We all have some. They are often caused by such stimulants as coffee, coke medications etc. In disease states, they can be caused by electrolyte imbalances or ever disease of the cardiac muscle itself. It is only when there are a lot ot them, when they persist and cause symptoms such as dizziness etc, that they should be looked into further and treated. Your toprol should help to keep the number of these under control because it is a beta blocker and it may help to control the symptoms of your panic attacks.
Q: Does anyone know the side affects of one med to the other condition? Asthma medication seems to make the pvc's and anxiety worse and the atenolol seems to make the asthme worse. So I am left to take more of each and it increases both conditions.
Q: Is there a medication out there that would help with the conditions but not cancel each other out?
Q: I need to stay active and work out, but running or aerobics seems to make pvc's worse. DO I run or not run? I have been told that my pvc's and mvp are nothing to worry about. Easier said than done, pvc's are worse after running and through out the next day. Any suggestions???? (also, sorry for the mistskes, computer won't let me correct them) oops :)