Concentric Left Venticular hypertrophy w/ abnormal diastolic filling parameter

[elegreenmachine]

My brief history is 35 Female, 75lbs overweight. History PVC's, SVT, 100/60, marginal hypertrophy of septum, poor excercise tolerance, Cur: TRI 305 HDL 18 LDL 148 Total 227. Meds: Toprol XL 50 Klonopin .5 Ativan 1 Asprin 162 Zocor 40 mag ox 1000 fish oil 2000 new 10 zetia.
1. Aug PVC frequency changed & how it felt changed. Getting several a minute & instead of the force in throat changed to flutter of stomach, documented by holter. Still feeling in stomach. Don't understand the different sensation. I started 3000 mg of fish oil, & 1000mg of magnesium oxide at that time. PVC frequency diminished after week on that.
2. In Oct noticed swelling in legs. PVC's were back. Started sleeping w/ legs elevated.  Made doctor appointment & couldn't get in until Dec. Called Cardio & put me on dyazide to take as needed. Only taken couple of times 1st time lost 10lbs. Plus pressure 80/50.
3. Saw doc & did chest x-ray saw something & requested echo. Echo states hyperechoic shadow in lung, had CT scan & showed scaring from inflamation otherwise normal. Echo stated Boderline concentric LVH w/ walls 12mm cross dimension, doppler interrogation no significant valvular abnormalities, although there is a marker of abnormal diastolic filling parameter identified. I also had normal systolic motion. Echo Nov 03 essentially normal, although abnormal echos in past.
4. I started diet Jan 1 & lost 12lbs. Don't know if I have heart failure. Cardio wants to try me on Aldactone 25mg. I don't know if Fish & Mag caused change or what. What is abnormal diastolic filling parameter? PVCs more serious now?

[CCF-M.D.-MJM]

Hello,

Sorry to hear about your recent health problems and I apologize for not answer your questions yesterday.

Abnormal diastolic filling parameters essentially means that your the pressure in your heart is higher than normal during the filling stage.  This can lead to shortness of breath, occassionally swelling, and sometimes even heart failure symptoms.

The significance of the PVCs all depends on whether you have a hypertrophic cardiomyopathy or if you have a thickened heart from from other causes (high blood pressure, being over weight and increased strain).  Has your doctor brought up the idea of a hypertrophic cardiomyopathy?  Do you have any family history of heart disease in young people or history of sudden death in young family members?  My guess is it is not a hypertrophic cardiomyopathy, but this should be investigated.  

Your cholesterol panel is consistent with a metabolic syndrome of obesity, increased triglycerides, and low HDL.  You need to lose that extra weight and I applaud your efforts thus far.  If you do not correct the weight problem and maintain a reasonable weight, it will likely lead to health problems in the short and long term....that is if it isn't already causeing the problems you have now.

I hope this helps and answer your questions and thanks for posting.

[CCF-M.D.-MJM]

Sorry I didn't answer the fish oil/mag question.

I see no problem with the magnessium supps.  I am not sure what they recommend as a stadard dosage of fish oil, but it should be safe and I don't think is contributing to your problem.

As far as the abnormal filling parameters--this is a very difficult concept.  Essentiallly it means your heart is too stiff, probably from the increased muscle.

I hope this helps...

[elegreenmachine]

I very much thank your for your response.  I wanted to let you know that HCM does not run in my family as far as I know.  Mother did pass away soudenly young in her 50's no autopsy so don't know direct cause, although she was obese, smoker and no excercise.  They said she probably had CAD.  But in family members who have had echos as well there is no evidence of HCM.  At one point years ago HCM was mentioned to me, but ruled out.  I have normal to low pressure, so I know that is not the cause either.  I have to believe it is because of my weight.  

With weight loss and proper diet for the rest of my life, would that reverse the abnormal diastolic filling parameter?  Can it go away?  Or does it always turn into heart failure?  I am so young and want to correct bad habits as I am mom and worry about leaving my children.

Also my question about the fish oil and magnesium supplements can that cause these problems.  Echo a year ago didn't show it, but now it does and that is the only thing that changed.  So I am suspect, although they do provide some relief to the PVC's, might be a mind thing but they do.  I just am not sure if I should stop taking them?  Without the mag supplements my mag was 2.6 now on them it is 2.0, which I thought was weird.

If you have a chance to respond again, I would apperciate it.  I understand your time is valuable and I would not want to take anything away from that.  So if you can't I understand.  I consider myself blessed for your response already.  Thank you so much!

[elegreenmachine]

I tried to get everything I could in the post. I wanted you to know I have had full cardiac work up in past including Normal Cath in 2000. & measurments on multiple echos since 1998 have always been on the upper limits of normal. Plus edema has been +2 to +3.  I just don't understand what the abnormal diastolic filling parameter is.

And I feel blessed to have been able to post a question.  You doctors are wonderful. As I am very scared about the new echo, and where my future lies.