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Heart Disease (Expert Forum)
Concerned about test results
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Concerned about test results
by ed6, Nov 23, 2005 12:00AM
I am an athletic 40-year old male, suffering from adhesive capsulitis but otherwise asymptomatic. I thought I had good heart health until I received results from an echocardiagram, a nuclear stress test, and auscitation. I have a mildly dilated right ventricle, mild triscuspid regurgitation, an LVEF of 51%(via gated imaging), a fourth heart sound and an atrial septal aneurysm. (A subsequent bubble study came back negative for shunting, and I achieved 14.8 METS in the stress test without arrythmias or other red flags; 2004 calcium score was 0.) These conditions have been described to me "normal variants", "low normal" and "benign abnormalities".
I am worried that all of these irregularities are not simply one big coincidence, and that, minus the aneurysm, they might be signalling the initial stages of a cardiomyopathy. The only change in lifestyle over the last year is an increased consumption of wine (2-3 glasses, 4-5 days a week), in order to lower my cholesterol, and less sleep. I have decided to forego further consumption on the chance that this might be causing my heart to enlarge and decline. My cardiologist wants me to have another bubble echo in 6 months, but thinks I simply have an efficient heart. But an echo from 1991 (at peak athleticism)revealed an LVEF of about 70 and no dilation of any chamber.
How likely is it that all of these results are consistent with good heart health? Is a 4th heart sound consistent with dilation?
Any suggestions on what I can do other than wait and worry for either six months or for symptoms would be appreciated.
I am worried that all of these irregularities are not simply one big coincidence, and that, minus the aneurysm, they might be signalling the initial stages of a cardiomyopathy. The only change in lifestyle over the last year is an increased consumption of wine (2-3 glasses, 4-5 days a week), in order to lower my cholesterol, and less sleep. I have decided to forego further consumption on the chance that this might be causing my heart to enlarge and decline. My cardiologist wants me to have another bubble echo in 6 months, but thinks I simply have an efficient heart. But an echo from 1991 (at peak athleticism)revealed an LVEF of about 70 and no dilation of any chamber.
How likely is it that all of these results are consistent with good heart health? Is a 4th heart sound consistent with dilation?
Any suggestions on what I can do other than wait and worry for either six months or for symptoms would be appreciated.
Doctor's Answer
by CCF-M.D.-MJM, Nov 23, 2005 12:00AM
Hi ED,
There is nothing alarming to me on the reports above. Your calcium score is perfect. Just about everyone has some degree of mitral or tricuspid regurgitation -- our tests are too sensitive. An atrial septal aneurysm is no cause for alarm but is associated with an increased chance of having a PFO. The mild RV dilation in the setting of an atrial septal aneurysm is suggestive of a PFO hence the reason your doctor wants to take another look in a few more months.
An S4 is associated with increased stiffness to the heart walls and is usually seen in people with hypertension or ventricular hypertrophy. These conditions should be ruled as causes of your S4. It also can be heard with dilation, but not usually mild RV dilation, typically more in the LV.
I hope this answers you questions. I don't think you have much to worry about here. 1-2 glass of wine per day for male is usually fine.
good luck
There is nothing alarming to me on the reports above. Your calcium score is perfect. Just about everyone has some degree of mitral or tricuspid regurgitation -- our tests are too sensitive. An atrial septal aneurysm is no cause for alarm but is associated with an increased chance of having a PFO. The mild RV dilation in the setting of an atrial septal aneurysm is suggestive of a PFO hence the reason your doctor wants to take another look in a few more months.
An S4 is associated with increased stiffness to the heart walls and is usually seen in people with hypertension or ventricular hypertrophy. These conditions should be ruled as causes of your S4. It also can be heard with dilation, but not usually mild RV dilation, typically more in the LV.
I hope this answers you questions. I don't think you have much to worry about here. 1-2 glass of wine per day for male is usually fine.
good luck
I had my EF go from 65-75 % to 55% in 5 years , I wouldn't worry too much about that , even though the printout stated 53%, the doctor said he estimated it at 55-60%. Unless your left ventricle showed signs of dilation i would take the docs word for it that these are normal variants, im no doctor but been told by many that if you look hard enough on any echo you will always find something a little out of the normal.
Can anyone tell me why it is for male and didn't mention female? For female is worse or ultra fine???
To be very honest i don't know but when i had pvcs very frequently in the 1000s daily i used to feel sob and lightheaded at times but no chest pain associated with them, as i understand it you can be very symptomatic with them it does not mean they are more harmful. If you feel lightheaded you shouldn't drive or be careful that you dont fall and hurt yourself, these things things can hurt you as a results of the symptoms from the pvcs, but the pvcs in themselves will not harm you, i am not a doctor but if your pvcs are causing you intolerable symptoms maybe its time to seek a second opinion and explore other treatments in helping you to deal with the symptoms from them.Sometimes they tend to cause you to hyperventilate which you dont even realize and this could account for the way the you feel. Good luck and a Happy PVC free Thanksgiving.
Yes the person n cardiology said the only fear is if I should pass out and hit my head, really makes me feel so much better...
atleast sarcasm takes my mind off my tight chest. Thanks Tick
I had good luck posting at that time, and I know others have also.