Asymmetric left ventricular hypertrophy & Dilated right ventricle
I am confused!
I recently had cardiac catherization which showed NO blockages! (A miracle in my family!)
An echo was done immediately following the catherization.
The echo indicated mild asymmetric left ventricular hypertrophy, a mildly dilated right ventricle, an EF 55-60%, mild aortic regurgitation, mild mitral regurgitation and trace tricuspid regurgitation. There was no wall motion abnormalities noted. The aortic root diameter is 3.3 CM (down from 3.9.. which doesn't make sense)
I am still very concerned because of ongoing extensive symptoms and the fact that I have extensive family history of cardiac disease.
Maternal grandfather - sudden death - MI early 40s
Maternal aunt - sudden death - MI early 40s, after several MIs
Maternal uncle - sudden death - MI early 40s, after several MIs
Mother - suddern death - MI 72 - numerous MIs and 2 CABGs - left ventricle hypertrophy - right ventricle dilated - HF
Brother - HF - CABG at age 56, angioplasties
Brother - MI, CABG at age 45
Brother - MI w/30% damage at age 32 - "timing" problems
Sister - MIs began at 39 - too many stents to remember, HF, defibrillator - now 46 years old
Father - MI complications of perforated colon during colonoscopy
Grandfather - sudden death - MI 62
Most importantly - my son, age 41 had an MI, was resuscitated and transported - received 4 stents
My siblings thing that they have ventricular hypertrophy or dilated ventricles, too but they are not sure!
My daughter has been having on going issues with arrythmia but has not been able to get a diagnosis. She is petite, thin and fit but almost passes out often.
Now.. to my symptoms.
I am a 60 year old female, chunky, not obese, never smoked, used alchol or used or abused drugs. I take allergy injections weekly, have mild hypertension treated with Cardizem LA.
I have been having ongoing shortness of breath, which has become intolerable. I have chest pain if I stand for more than a minute. I have been experiencing periodic episodes that wake me in the night with chest pain, sweating and shortness of breath.
When I sit or lay down, my blood pressure and heart rate are about 110/70 with a heart rate of 58. When I stand, my systolic pressure remains about the same but my diastolic pressure immediately goes to 110 and continues to climb. My heart rate goes to 120+. After a while, my blood pressure will not register on my machine. I begin to sweat profusely, my face becomes red, my heart hurts! I have tremor. My legs and arms are shaky.
I am dizzy sometimes overwhelmingly so and I have been experiencing headaches or more like episodes where my head really hurts. I have intermittent nausea especially after standing.
I have tried for years to resolve my shortness of breath but have been unsuccessful. I have had chest pain most of my life but had not been concerned. I was told it was nothing by my cardiologist.
I do have a pulmonary disfunction in that I have an air diffusion of 51%. I do not know why. I do not have pulmonary hypertension, the catherization confirmed that.
I may or may not have asthma depending upon which doctor you ask.
I have an elevated normetanephrine 1.3 (normal <.9).
Holter monitor demonstrated frequent ventricular ectopic beats, 37 supraventricular ectopic beats, isolated PACs, couple PACsone 5 beat atrial tachycardia at 150 bpm. During maximum sinus rate there was some mild, fairly horizontal or slightly downsloping ST segment depression. Notation that myocardial ischemia could be considered.
When the holter testing was done, I felt too weak to do anything but rest. The only thing that I did exertional was blowdry my hair. That activity caused the high bpm.
I would appreciate any insight that could be offered.
"The echo indicated mild asymmetric left ventricular hypertrophy, a mildly dilated right ventricle, an EF 55-60%, mild aortic regurgitation, mild mitral regurgitation and trace tricuspid regurgitation. There was no wall motion abnormalities noted. The aortic root diameter is 3.3 CM (down from 3.9.. which doesn't make sense)"
The aortic root diameter is an estimate and usually the area closest to the valve is narrower. So the variation may be due to exactly the location measured, regardless it doesn't appear to be an issue.
A 64 slice CT angiogram takes images of the anatomy of the vessels, and for someone who has a family history, it seems that would be an appropriate test. A cath angiogram just views lumen and should see any large blockage.
Are you taking medication such as a beta blocker. That can cause some fatigue.
A faster beating heart may have induced ischemia and that can be an explanation regarding high sinus rhythm and slightly depressed ST on an EKG?!
I did do a Coronary CTA in May. I was trying to avoid a catherization to be honest!
The results showed a mild plaque burden of 50.
It stated that there was a small circumflex artery that very quickly leaves the AV groove and becomes a marginal branch to the left ventricle.
There were 2 very small peripheral calcified plaques in the proximal RCA.
It indicated a 7MM long, densely calcified plaque in the proximal LAD lumen, distal to the 1st diagonal branch, which obscured the lumen in the images.
That was disconcerting!
When the cath was done, the cardiologist said that the calcified plaque must be lying on the outside of the LAD arterial wall and that there were no blockages.
He also measured the pulmonary artery for hypertension and told me that I do not have pulmonary hypertension, which is great!
Initially, the cardiologist thought that I would be stented but once the procedure was underway, he soon assessed that it wasn't necessary.
My family was elated!
The cardiologist and his research assistant were very complementary of my proactive care which has included Lipitor for 10 years, zetia, flaxseed oil and a few other vitamins. My cholesterol levels are excellent. They felt that this has helped me despite my family history.
I am not on a beta blocker because I take allergy injections and beta blockers can not be used with them.
I am very concerned that I am unable to stand for more than a moment or two!
I do remember my mother having the red face with minimal exertion, the sweating, fast heartbeat and trembling.
I do know that I am fighting genetics, but I am just not sure what is going on!
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