Aa
New diagnosis
Hi ,
My name is Andrew I was diagnosed last week. My echo came back with moderate mitral valve regurgitation, moderate left ventricle dialation, moderate systolic LV dysfunction, and severe Left atria enlargement.
My EF if I am reading the echo document correctly says 57%?
I wish I could say it was a shock I knew for months something was wrong ( waking up gasping , always tired, tachycardia , very faint pulse,) My Gps put it all down to anxiety and were ready to start me on anti-depressents!
I have suffered from paroloxsymal AF for 5 years and had an echo back in October which my cardiologist seemed ok with (I find him a little obtuse at times) although maybe things have got worse. To be fair he keeps me in the dark, its only because I turned up at A and E with chest pains and AF that the NHS sent me for another echo that these latest results were obtained.
Anyway I had a catheter ablation for the AF on the 14th April that was before these results were known. I am thinking surely my EP would have cancelled if he had known. I did try to sabotage the op as I emphasised I was not 100% (and now we know why)
I am due to see my EP tomorrow so it will be interesting to see what he says.
Anyway I have been reading all the posts on here with great interest it seems I am in the right place and would be grateful for any initial comments as I start on my journey with you inspirational people.
Andrew
My name is Andrew I was diagnosed last week. My echo came back with moderate mitral valve regurgitation, moderate left ventricle dialation, moderate systolic LV dysfunction, and severe Left atria enlargement.
My EF if I am reading the echo document correctly says 57%?
I wish I could say it was a shock I knew for months something was wrong ( waking up gasping , always tired, tachycardia , very faint pulse,) My Gps put it all down to anxiety and were ready to start me on anti-depressents!
I have suffered from paroloxsymal AF for 5 years and had an echo back in October which my cardiologist seemed ok with (I find him a little obtuse at times) although maybe things have got worse. To be fair he keeps me in the dark, its only because I turned up at A and E with chest pains and AF that the NHS sent me for another echo that these latest results were obtained.
Anyway I had a catheter ablation for the AF on the 14th April that was before these results were known. I am thinking surely my EP would have cancelled if he had known. I did try to sabotage the op as I emphasised I was not 100% (and now we know why)
I am due to see my EP tomorrow so it will be interesting to see what he says.
Anyway I have been reading all the posts on here with great interest it seems I am in the right place and would be grateful for any initial comments as I start on my journey with you inspirational people.
Andrew
Ok had results from my MRI scan they say heart a little enlarged (I will have to come in and see them for the the figures) Mixed news although Mitral valve reguritation now classed as moderate and ejection fraction 67% they say I had a small heart attack around the circumflex artery. Ventricular function now normal and MVR not at a stage where it needs treating as yet. I will have to go on and see Consultant about the heart attack and I wonder why this never showed on tests when I went to A and E and had numerous EKGS?
Cardiac magnetic resonance (CMR) is increasingly utilized for dynamic imaging of the heart. It will provide more accurate and reproducible measurements of cardiac chamber dimensions, volumes, and function compared to echocardiography. It is a lot more expensive than an echo though.
I assume that your cardiologist will use the MRI report to validate/invalidate the results of the earlier echo.
Also, it will enable him to better analyze the cause and find a remedy for your problems.
I assume that your cardiologist will use the MRI report to validate/invalidate the results of the earlier echo.
Also, it will enable him to better analyze the cause and find a remedy for your problems.
Hi
I have received my date for the MRI 4th July.
Would they be able to tell if the leaky valve is causing the remodelling and hopefully look to a MV repair after the scan?
What are they specifically checking with the scan?
I have received my date for the MRI 4th July.
Would they be able to tell if the leaky valve is causing the remodelling and hopefully look to a MV repair after the scan?
What are they specifically checking with the scan?
Yes, trying to get the AF under control could be a good approach.
He is the doctor and knows so much more than we laymen.
But why would he doubt the echo then? Perhaps he only said so for your ease of mind?
MRI's often have a long waiting time. But you can always try. :-)
Please let me know the outcome of your consult?.
All the best,
Ger
He is the doctor and knows so much more than we laymen.
But why would he doubt the echo then? Perhaps he only said so for your ease of mind?
MRI's often have a long waiting time. But you can always try. :-)
Please let me know the outcome of your consult?.
All the best,
Ger
Atrial fibrillation can cause dilation of the atrium, which in turn can cause increased leakage of the mitral valve (because the annulus of the valve is dilated too).
AF in itself does not cause the ventricle to enlarge however.
The left ventricle enlarges because of excessive workload. This can be from high blood pressure, a narrowed aortic valve, excessive backflow from a leaky mitral valve and probably more.
Your echo results point in the direction of the leaking mitral valve as the cause. Other abnormalities are not reported.
Whether it leaks from the AF or from other causes I can't say.
If your doctor can get the AF under control, perhaps your left atrium can get back to normal size and your mitral valve leakage will also get less.
Anyway, if your heart is in the process of adapting strongly to the mitral leakage, something needs to be done, especially as you experience symptoms. If you wait too long, the adaption will become irreversible. It may not be a matter of weeks, but in a couple of months it could worsen noticeably.
Of course, if the echo is wrong, all the above is to be discarded, but why should the echo be wrong? An unexperienced examiner or so? Not very likely.
The echo shows and reports heart functions and dimensions. I do not see why AF, although it can cause abnormalities, would invalidate the echo report.
If your doctor thinks the echo is not valid, he should order a repeat echo to rule out that possibility.
With your symptoms, I would try to get the MRI sooner if that is possible.
AF in itself does not cause the ventricle to enlarge however.
The left ventricle enlarges because of excessive workload. This can be from high blood pressure, a narrowed aortic valve, excessive backflow from a leaky mitral valve and probably more.
Your echo results point in the direction of the leaking mitral valve as the cause. Other abnormalities are not reported.
Whether it leaks from the AF or from other causes I can't say.
If your doctor can get the AF under control, perhaps your left atrium can get back to normal size and your mitral valve leakage will also get less.
Anyway, if your heart is in the process of adapting strongly to the mitral leakage, something needs to be done, especially as you experience symptoms. If you wait too long, the adaption will become irreversible. It may not be a matter of weeks, but in a couple of months it could worsen noticeably.
Of course, if the echo is wrong, all the above is to be discarded, but why should the echo be wrong? An unexperienced examiner or so? Not very likely.
The echo shows and reports heart functions and dimensions. I do not see why AF, although it can cause abnormalities, would invalidate the echo report.
If your doctor thinks the echo is not valid, he should order a repeat echo to rule out that possibility.
With your symptoms, I would try to get the MRI sooner if that is possible.
1 Comments
Ger, all very valid comments. I am going to insist on another echo which will be useful as he doubts the validity. I have no idea if I can get the MRI scan earlier , to be honest I think part of his reasoning for the 8 weeks was to try and get the AF under control with this new medication Amidarone and see where we are with that.
Hi Andrew,
I too have moderate mitral regurgitation, but without the enlargement of atrium and ventricle.
Normally, if moderate leakage is found, the patient is monitored yearly to see if there is progression of the condition.
If there is, they try to find the optimal timing to do repairs to avoid the heart adapting too much to the new, leaky situation
If the heart can not handle the amount of leakage, it starts to compensate which results in abnormal sizes of left ventricle and atrium. This should preferably be prevented or kept limited as it will eventually end in heart failure.
I am no doctor but it seems to me that you are in this compensation phase.
Your EF (ejection fraction) is still good (normal range is 55-70%), but your left atrium is enlarged from the amount of blood that flows back from the ventricle and your left ventricle is enlarged and stiffened while trying to pump enough blood through your body .
It is a bit premature perhaps to say, but if it is the mitral valve that is causing the trouble, there is a good chance that they can repair it, often with minimal invasive surgery. Once the leakage is reduced, your heart may (at least partially) regain is normal size.
Hope this helps you a little.
God bless,
Ger
I too have moderate mitral regurgitation, but without the enlargement of atrium and ventricle.
Normally, if moderate leakage is found, the patient is monitored yearly to see if there is progression of the condition.
If there is, they try to find the optimal timing to do repairs to avoid the heart adapting too much to the new, leaky situation
If the heart can not handle the amount of leakage, it starts to compensate which results in abnormal sizes of left ventricle and atrium. This should preferably be prevented or kept limited as it will eventually end in heart failure.
I am no doctor but it seems to me that you are in this compensation phase.
Your EF (ejection fraction) is still good (normal range is 55-70%), but your left atrium is enlarged from the amount of blood that flows back from the ventricle and your left ventricle is enlarged and stiffened while trying to pump enough blood through your body .
It is a bit premature perhaps to say, but if it is the mitral valve that is causing the trouble, there is a good chance that they can repair it, often with minimal invasive surgery. Once the leakage is reduced, your heart may (at least partially) regain is normal size.
Hope this helps you a little.
God bless,
Ger
1 Comments
Ger , thanks so much for your input...Ok I had an hour long meeting with my EP who showed me the Echo from October.
It was amazing the difference in the 6 months , no LV dysfunction only mild regurgitation from the mitral valve , only mildly dilated Atria!!!
He thinks there has been a mistake with this latest Echo or its wrong due to the fact ive been in AF a lot which can affect it he says? He also says if the EF is 57% it also makes him question the validity of the Echo?
He has prescribed Amioradone for the AF, caverlilol and Rampril for the Echo results plus Rivoroxaban. He has booked me in for an MRI heart scan for 8 weeks time.
To get such a varied report in such a short period of time maybe suggests DCM? I am just so confused with it all as I guess its hard to make a prognosis with so much going on...all I know is I feel tired and poorly and want the best course of action asap.
It was amazing the difference in the 6 months , no LV dysfunction only mild regurgitation from the mitral valve , only mildly dilated Atria!!!
He thinks there has been a mistake with this latest Echo or its wrong due to the fact ive been in AF a lot which can affect it he says? He also says if the EF is 57% it also makes him question the validity of the Echo?
He has prescribed Amioradone for the AF, caverlilol and Rampril for the Echo results plus Rivoroxaban. He has booked me in for an MRI heart scan for 8 weeks time.
To get such a varied report in such a short period of time maybe suggests DCM? I am just so confused with it all as I guess its hard to make a prognosis with so much going on...all I know is I feel tired and poorly and want the best course of action asap.
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