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CARDIAC ULTRASOUND
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CARDIAC ULTRASOUND

I am a 31 year old male.  I exercise 6 times weekly (High Intensity) running and sprinting and heavy weight lifting.  Sometimes two session (morning lift/afternoon run).  I have been running (30-60 min) for about 12 years.  I have mild hypertension which is well controlled with Diovan 160mg daily.  Recently I was having breathlessness, racing heart (particularly during exercise), palps, and anxiety.  Blood work has revealed painless Thyroiditis (Very Low TSH, High T3, Low Radioiodine Uptake).  In the meantime a CARDIAC ULTRASOUND was orderd and the results are below.  Are these values representitive of Heart Disease (Particularly the biatrial enlargement), or could the enlargement be due to my history of athleticism.  Thanks very much in advance.
  
      LA DIAM     (1.9-4.0): 3.8 CM       LVIDD  (3.7-5.6): 5.1 CM
      AO ROOT DIAM(2.0-3.7): 3.4 CM       LVIDS  (2.0-4.0): 3.1 CM
      POSTER WALL (0.6-1.1): 0.9 CM       SH FRACT (28-46):  39  %
      SEPTUM      (0.6-1.1): 0.9 CM       RVIDD  (0.7-2.6): 2.5 CM
      -------------------------------------------------------------
      LVOT DIAM   (1.5-2.4):   - CM       LA VOL   ( <50 ): 63 mL
      ASC AO DIAM (2.0-3.7): 3.2 CM       RA VOL   ( <50 ): 58 mL

INTERPRETATION:
   1. The left ventricle demonstrates normal and systolic diastolic
      dimensions, left ventricular wall thickness is normal.  Left
      ventricular systolic function is normal with a calculated apical
      biplane ejection fraction of 57% and normal regional wall motion.
   2. There is a false tendon noted in the mid left ventricle.
   3. The right ventricle is normal in size with normal right ventricular
      systolic function. There is a moderator band present in the apex of
      the right ventricle.
   4. The left atrium is mildly enlarged though there is mild biatrial
      enlargement and an intact interatrial septum.
   5. The aortic valve is trileaflet with no evidence of AI or AS.
   6. The mitral valve is structurally normal. There is trace mitral
      regurgitation.  No mitral stenosis.  Mitral inflows demonstrate
      normal diastolic parameters and tissue Doppler E/E' ratio of 4 is
      consistent with normal estimated left atrial filling pressures.
   7. The tricuspid valve is structurally normal. There is trace tricuspid
      regurgitation.  The peak regurgitant velocity is 2.8 m/sec
      correlating to a peak estimated PA systolic pressure of 30-35 mmHg.
   8. The pulmonic valve is structurally normal. There is trace to mild
      pulmonic insufficiency.  No pulmonic stenosis.
   9. The IVC is normal in size and demonstrates normal inspiratory
      collapse.
   10. There are no masses or effusions.
   11. The ascending aorta and aortic root are both normal in dimensions.
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367994_tn?1304957193
Your left vetricle functionality is good indicated by fractional shortening of 39% (Calculation is derived from left ventricle dimensions....percentage of the difference size when chamber has completed filling and size after completion of pumping).  Ejection fraction is good.  Same formula as Fractional shortening but the volume of blood  is the component measured (normal is 55-75%...amount of blood pumped into circulation with each heartbeat).  You have a good, strong heartbeats.

As I know In biatrial enlargement it is the ECG  reading whose signs of both left and right atrial enlargement.  If considered significant there requires clinical evidence to make a differential dianosis: valve disease...stenosis or regrugitation... impressions are negative, decreased left ventriclar compliance...negative finding,   long standing hypertension...??? obstruction myocardiomyopathy, etc.  There is no clinical evidence to support biatrial enlargement as your hypertension is under control!

An "Athletes heart" is a non pathological enlargement of the left verticle.  The heart's funcitionality is very efficient meaning the heart  pumps fewer times for an adequate cardiac output.  Also, at rest the heart beats less than 60 beats per minute.
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