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Echo Results to rule out lvh & mvp
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Echo Results to rule out lvh & mvp

i'm 35 years old 5'6 160 pounds. havent exersized in almost 2 years. no drinking , no drugs heavy smokings. slightly high cholesterol.

had this echo done a month ago. had a visit with cardio a week ago who suspected mitral valve prolapse. possible lvh also showed on numerous ekgs although most doctors say no i don't have lvh.

first cardio from a month ago says no lvh, no mvp
here are the findings

LEFT VENTRICLE - Diastolic Dimension 4.4 cm, Systolic Dimension 3.3 cm, IVS 1.2 cm, Posterior Wall 1.2 cm, Left Atrial Dimension 4 cm,

AORTA -  Aortic Root 2.5 cm

EJECTION FRACTION - 60 %

MITRAL - Peak Gradient 3.1 mmHg, Peak Vel E/A  88/88 Cm/s,  Dec Time 108 msec, E/A Ratio 1

1. So do i or do i not have lvh or mvp? first cardio after looking at this says no to both, second cardio has not looked at it yet but he thinks he hears a click suspecting mvp

2. i do not exersize which tells me if i do have mild lvh it can't be due to exersize right? although i used to work out quiet a lot a couple of years ago and grew up very active

3. if i do have lvh will it progress?

4. is lvh reversible? if so how?

5. i was told for months since starting  pvcs that with an "otherwise healthy heart" pvcs are not to be worried about. does this change things now?

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213398_tn?1202674074
forgot to mention the echo study says under findings "mild left ventricular hypertrophy" if this sheet says this then why do docs that saw the echos say it is normal????
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Michael, maybe you should concentrate more about #2 above.  You should start some exercise program and stop fixating on a problem the doctors tell you does not exist.  Diet and exercise are the major key to physical and mental stability.  Step back from the keyboard and take a walk.  You need to stop the IFs and concentrate on the IS.  You have a "otherwise healthy heart", for goodness sakes, celebrate that!  
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hi Florida. thanks for your response. see thats the whole thing. do i have a "otherwise healthy heart"
i see in most posts here that pvcs do not pose a danger if you have a "healthy heart" yes the first cardio told me that i do not have mvp nor do i have LVH. but the second cardio i went to just to make sure i was fine told me that he hears a click and that he would confirm it with an echo. so i went to the first cardio and got the results. report says mitral valve is normal , however the report also states that i have mild LVH .  1.2 cm which puts me right on the border just going into LVH basically. originally the reason they did an echo is because tons of ekgs said possible LVH. after the echo the first cardio told me no lvh no anything. so now i'm wondering why would this report state mild LVH the echo report. so that's why i'm concerned because i'm guessing this means i no longer am considered a "healthy heart patient" with pvcs??? very confsused and worried. Also i have no clue why i would have even mild lvh. i'm not overweight and i do not have high blood pressure. although i probably get spikes of high blood pressure from anxiety disorder when it acts up
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21064_tn?1309312333
Listen to your doctor.  Sometimes the reports generate a diagnosis based on the data supplied.  It is the doctor's job to correlate the patient's symptoms to the clinical data and interpret the test.  In other words, the computer generated diagnosis is based on the "data" from your EKG or echo or whatever test you have.  The doctor must put the whole picture together to form an accurate diagnosis.

If I went by the diagnoses printed out on my reports, things look quite a bit worse than they really are.  My EKGs print out things like "long QT, possible prior myocardial infarction, etc.  However, after my doctor reads the report, she correlates her clinical evaluation to the tests and comes up with a "real" diagnosis.

Repeated echos say my atrial volume index is "significantly abnormal" when in fact it is not.  My doctor explained that the computer made assumptions about me and came up with its own conclusions. That's why it is SO important to wait until the doctor gets the results and interprets the tests to your clinical presentation (symptoms, appearance, etc).

Several years back, I went for a routine echo and the report said that my mitral valve was "SEVERELY" leaking."  Some follow up tests showed otherwise.  So, what I'm saying is, don't go by the written words as much as what your doctor tells you.  Let it go and get on with your life.  Exercise, join that triathalon and forget about trying to find something wrong.  Your heart is fine, except for the anxiety.  Have a good day!
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216614_tn?1195668672
in the analogy above...the ants are the pvc's      the elephant the anxiety....
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216614_tn?1195668672
MICHAEL.....stop.....you are obsessing over ants and letting the elephant bulk up.  You continue to fret over this and you WILL make yourself sick.  Stress can cause issues.  You have been told by the docs, by everyone on this board who has the same issues and the knowledge...what will it take to convince you?  As Brat said, start concentrating on #2..the exercise will keep you busy and you won't be sitting sitting here obsessing..not to mention the exercise can only help.  You are wasting your youth!  Don't let you life slip by while you worry about dying.  In the end you will have missed it all.
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ants?  elephants bulking up? anxiety? huh?  But what is wrong with his heart?  Can anybody answer THAT?  There must be something wrong.....he got some PVCs.  This is too confusing for me.
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I feel your pain... I just had an echo done two weeks ago, the tech kept telling me everthing looked great. I called and got the prliminary results over the phone (big mistake) and was told I have mild LVH for the first time. I do exerise daily, 45 mins on a treadmill to burn 500 calories.

Long story short, I had the face to face follow up with my cardilogist this week to go over the report and asked her about the LVH. She told me that mild LVH starts at 1.3 cm and mine measured 1.2 cm, no problem yet just something to watch. That's part of the confusion, it depends on what you read but I saw reports that LVH starts at 1.2 cm, another report showed 1.3 cm and another 1.5 cm. The Cleveland Clinc reports that mild LVH starts at 1.3 cm, they agree with my doctor and that's what I'm going with! She also said that exercise would most likely not cause this unless you are an elite athlete. I also have a slightly dialated left atrium, which could be exercise related. All valves good with only trace leakage in my triscuspid valve which she says is a very normal finding. Normal LV function and size and everything else within normal limits. I asked the question "do I have a structureally normal heart" to which she responded yes and any PVC's were completely normal. My guess that is the same case with you. Have you asked your cardio this question?

I agree with everyone else, get on a exercise program to get you mind off your heart. One of the reasons I do it is beacuse of the peace of mind that if I can make my target heart rate goals without symptoms then the odds are the ticker is fine, which is what my cardio also says. Not to mention the benefit of loosing 60 pounds in 13 months. When we finished our meeting, she actually told me I no longer need a cardiologist and does not feel annual check ups are necessary and if I want to repeat the echo in 2 or 3 years, let my family doctor know, otherwise they'll just be there if I ever need them

Good Luck.
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216614_tn?1195668672
My concern for Michael's heart is all this needless stress will lead to stress induced DCM...
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What Often said goes for me too.  I am beginning to suspect that you are either an engineer or a lawyer, with all the over analysis and tendency toward perfection. (btw, I am not bashing them, before someone jumps all over me......one of my boys is an engineer)   But what exactly will it take for you to believe what you have been told?  You ARE reading all the responses to your many posts, right?  You have had doctors from the very best heart hospital in the entire country tell you that you are ok!  BELIEVE THEM!  Please.
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213398_tn?1202674074
yep thats basically where i stand too. mine measure at 1.2 cm for both poserior wall and IVS. according to the report it says "mild lvh" but doc says no. i don't get it. if studies say 1.2 cm is mild lvh then why do my docs say no?? also if it is mild lvh. my concern is that as i know lvh is a progressive condition, why makes me think i'm 35 now how bout 3 years from now will it be 1.3 1.4 1.5 ? i dont even know why i would have to it begin with? i'm not really overweight. i'm 5'5 160 pounds yes i do smoke a ton but i don't drink nor drugs. i have been under severe stress lately and have been having bad panic attacks so my though is that this causes spikes in my blood pressure that perhaps developed mild lvh. either case if i do have it is it reverseble? i know that if lvh progresses it will lead to heart failure so what keeps from me getting worse?
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uh oh....  MICHAEL!!!!  The smoking is a NO NO.  If you are as truly concerned with your health as you seem, what's up with the smokes???  I bet you have never heard that before.  (I know, I used to smoke and heard it countless times.)  Find something else to soothe the stress because this choice is a killer. Do yoga, write hiakus...just dont smoke.  I hope whatever is causing this extreme stress gets resolved soon. (Between you smoking and my boy Dan finding alcohol I am at wits end!)
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Brat...what is up with your boys....

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216614_tn?1195668672
As you sit there worrying about 1.2 , 1.3  who is right ? Will it be 1.4, 1.5 in three years?.....think of this...

I have said this before ...  I will say it again...   Who is to say you won't die of something else tomorrow..my lord....stop this.  Listen to the docs.  Listen to these people here who you are asking questions of.  

If you are not going to listen, why in hell are you asking?  Everyone has given you their stories, their feelings, their assurances.  It is time to let this go.  

Quit the smokes....you are worried about a benign issue with the heart and you smoke....so why aren't you worried about lung cancer?  Prostate cancer?  Emphysema?

Oh...BTW....heart failure is treatable. ..   living proof here....   but why worry yourself into it



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also living proof.  and living well at that!
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I too had an echo result which showed "severe" leakage, and it turned out false.  I also had an EKG which showed a previous heart attack which turned out false.  These "false" test results can scare the hell out of you.
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21064_tn?1309312333
LOL!!  I know what you mean.  Now, I wait for the doctor to tell me what the test results mean.  Those computer generated statements are so often wrong, and brutal for us patients!

Have a great weekend!!  Stay cool.....It's been over 100 degrees here!!  

connie
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213398_tn?1202674074
so you guys are telling me echo results can be false? i don't get it. i heard about ekg suggestions of possible lvh being wrong but how can an echo be wrong. i mean i heard it measures the size of walls and in my case it showed 1.2 for ivs and posterior wall. i just want to know if anyone else went through this and what is the explanation of a cardio saying no lvh and nothing to worry about. normal heart. is there something that tells them that this will not progress and become moderate lvh or something?
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Michael...I suggest you read Toneman's post again...up above.  No one can promise you that this will not progress and become moderate lvh....no one can promise you that the guy down the street won't shoot you in the back, no one can promise you that the world won't come to an end tomorrow.
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An by the way,

I had two echos done within a month of each other when I was first diagnosed with CHF.  The results were different.  Two different machines, two different techs, two different readers and two different docs....go figure.  

Get over it, kid.
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i'm not looking for promises. i'm just trying to find out, with a 1.2 reading are most people told they do not have a problem? i mean from what i can see people who say they had 1.2 then had 1.4 like 3 years later and so on and so forth. so doesnt this indicate a progressive disease? also i know that lvh happens with hypertension. i do not have high blood pressure. i only have spikes of high blood pressur from panic attacks. doesnt this put me at risk for developing heart failure? more lvh=heart failure ? no?
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Michael, have you put in as much effort to see what is causing your panic attacks and how to control them?  If your HBP is only during the attacks, then that seems to be the avenue to work on.  What are your triggers, how can you control them?  What can you do to avoid the situations that start the attacks?  
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and as far as a progressive disease, look to diet and exercise to halt the progression.  It is possible.
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213398_tn?1202674074
no i have not put in as much effort into panic attacks. panic attacks cannot kill me or make me severly ill, however lvh and the likes can make me sick so i'm trying to find out why someone my age would be on borderline or mild lvh. i mean if i'm 35 and i have this stuff now god knows what it will be a few years from now. so i'm trying to do research on this stuff from other people and nip this thing in the bud before it goes further. panic attacks do not even bother me anymore. i'm more worried about a real problem i may be facing. now as i now if 1.2 mm is mild lvh i'm trying to keep it from getting worse so i need to know why i would have this slight lvh to begin with . if anyone here has experience with this help would be much appreciated. and also if anyone has knowledge on how to regress it so that i can go on with my life not worrying that it will get worse in years to come. thanks everyone
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21064_tn?1309312333
Stop smoking
Eat a healthy diet
Stop smoking
Exercise
Stop smoking
Routine checkups
Stop smoking


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Avatar_n_tn
Yeah, Brat!  Who said panic?  This is a real problem, that can be fixed, then we can concentrate on the pvcs better.  No panic here.  Just hypochondria.  Knowledge is power you know.  ( although I prefer the expression that ignorance is bliss.)  Anyway, Mike is right........panic attacks cannot kill you..............they can just make it so you never really live.
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No more whining until you quit smoking......haven't you heard the latest medical discovery??  Those cigs cause lung cancer.  Really.  It is proven.  Emphysema too.
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i feel like most people are not being really helpful when telling me such obvious things like quiting smoking. i realize i have to quit and i have quit. i'm not asking about help with that stuff. i want to know if i already did damage to my body. i think the questions im asking are completely legitimate

1. there is another post on this site from a person concerned if he developed lvh from anxiety produced hypertension as opposed to regular hypertension. so my concern is chronic anxiety that produces spikes of hypertension could that have given me this marginal lvh that i may have?? by the way the cardio's response to this question on the other post was "unknown' meaning he is not sure if that could be the cause.

i really would appreciate other's help on here, telling me the obvious that i already know and am following does not help me. we are all on this site cause we are all concerned so i would really appreciate it if you just stop putting me down like a hypochondriac and only help by answering questions. if you don't know the answer i would appreciate put downs to be kept to your self. i'm sure when you were freaking out and that is the reason you are here to begin with you would not like someone telling you you are just imagining and not really answer the questions you had. thank you
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My echo results are almost identical to yours (from a 2003 echo)   Here are yours and mine in brackets.

LEFT VENTRICLE - Diastolic Dimension 4.4 cm (4.9cm), Systolic Dimension 3.3 cm (3.2cm) , IVS 1.2 cm, Posterior Wall 1.2 cm, Left Atrial Dimension 4 cm (3.9 cm),

AORTA -  Aortic Root 2.5 cm (2.6 cm)

I too have 1.2cm in both posterior and IVS.   My PCP never even told me about it (nor did my cardiologist)   It wasn't until I ordered the echo report that I saw "borderline left ventricular hypertrophy"   I saw a new doctor and he was the only one that wanted me to get a repeat echo (which I have yet to do and frankly dont want to)

I used to be on blood pressure medicine (probably white coat hypertension) but have since stopped after one doctor said I could.   My blood pressure at home ranges from 118/80 - 132/85 depending on the part of the day.   However, I found that if I get stressed (like right before a Dr's appt) I took my bp at home and got 170/99... or anxiety can still spike it to 155/90 (at Walmarts bp machine) but as soon as I get home and relaxed its back around 120/80.   So I think anxiety produced hypertension is a possiblity.    

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You got far too much attention here, more then your concern would need.
  So show a little appreciation would you?
You are upset  because you don’t want to hear what the others saying just waiting  something to hear what they don’t know: what for you in the future?
You know we all must accept our condition and our DX on one point and do the best with our power to live a heart friendly life for our own interest and for the simple reason we don’t want to stress our heart more then it is.

Now your DX is ; Healthy Heart….

Your question is can you develop more the years to come? If I get it right?

My answer sure you can…or can not. Who knows…one thing for sure if you fallow the “obvious” you have better chance NOT to develop Heart disease.
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can anxiety kill you?  Yes.  That is obvious, you know that .  CONGRATULATIONS!  You said you stopped smoking!!!!!
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Yes, congratulations on dropping that nasty smoking habit.  Your sense of smell and taste will be so much better!
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216614_tn?1195668672
your problem is that you want an absolute answer...and it can't be given.  Yes...it could progress..but who knows if it will or not.  NO ONE!.  It depends....that is the correct answer....it depends.  So...continue to do what you can to live a heart healthy life and get retested in a year.  
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You could also be run over by a bus crossing the road.  Look both ways before you cross the street.  This correlates with the stoping smoking, exercise program and watching your diet, you are looking both ways for your heart.  I surely hope you live to a healthy ripe old age.
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thanks for writing me. you are right i actually have almost identical findings to yours. i'm just very curious as to why the doctors would not mention these findings to me ,  i saw it for my self when i picked up the echo report. anyway like i said i realize that a finding of 1.2 is marginal lvh but still so curious as to what could have caused this borderline finding. i do not have sustained hypertension nor am i a superathlete which usually constitutes for these marginal findings. so what caused this and would a doctor not want to find out if there is an underlying condition that would cause this so as to "nip this in the bud" before it gets worse and is then something to be concerned about? i may have a slight sleep apnea which anyone who knows about this condition knows that it causes spikes of hypertension during sleep and i also suffer from panic/anxiety symptoms that cause spikes in hypertension. so even though a docs office shows normal bp at times and abnormal bp at times. i'm guessing those spikes could have caused mild lvh . any ideas? i read a study that was conducted on sleep apnea patients with lvh and those who treated sleep apnea actually regressed their mild lvh. anyway marksman i'm curious why don't you want to get the second echo as your doctor suggested?  you mentioned that your bp is under control now so maybe you regressed your lvh and it is now under the "normal" limits
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I was actually referred for a systolic murmur since birth but they found nothing wrong (3rd echo in my life and still shows the same)   I'm not concerned about the borderline LVH because my cardio nor doctor even mentioned it to me... then a third doctor I saw (while looking for a new one)  said nothing either.   It wasn't until a forth doctor that he said he was concerned.   Since the echo didn't show any valve abnormalities and I do get spikes in blood pressure (I am very anxious alot of time and worrying about these things makes it spike worse) that I think thats what caused it... anxiety.   There was another post on a forum that helped ease my fears on lvh... I dont recall where it was but somebody had a 1.3cm for both measurements.   The next echo showed .9 for both, two months later shows 1.2 and a year later showed something like 1.0    The person stated he did nothing different and that echo's aren't always accurate with those measurements.  

I dont go for an echo because I've built this anxiety about needing to go back.   They found nothing wrong with my heart so I dont feel I should have to go.   The cardiologist said "You have a normal heart and enjoy a normal life"  he added I could come back in 2-3 years if I like but nothing should get any worse if it hasnt already.
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hey. gotcha. weird. when i was young my parents told me the docs all thought i had a murmur and arrythmia as well and then a cardio ruled it out. as far as lvh goes im' still trying to get answer on how to control it. its tought to explain to most people the concern i have. i realize that being 1.2 is borderline and does not put me at risk. however i have a feeling that i did not have 1.2 all my life i most likely developed it in the last few years now being that i developed it lately my concern is that it can develop even more in a couple of years and no longer be "borderline" so what i've been trying to do is get advice for "preventative" medicine so that i don't have to get lvh not just borderline but actual lvh with time. my guess is that i probably developed it with severe stress and anxiety as well. even though most docs say lvh is caused by chronic hypertension. i've read some studies that show that spikes in blood pressure can possilbe cause mild lvh. i know i need to treat anxiety disorder but as most people with anxiety disorder already know it is not that easy. you can't just "get over it" so basically i'm trying to find out if in fact this anxiety disorder and spikes in pressure can be the culprit for marginal lvh and how to keep it at bay so that it does not get worse. i've noticed in the past few years battling with anxiety disorder that exercize is the only thing that makes it go away , however i read reports saying that exercize may cause lvh. so what can i do about that? not exercize ? very confused. lately i've been thinking about joining a martial arts class and again i'm having second thought, martial arts = development of lvh? yes no? i'm curious to the post you are referring to about the guy who jumped from 1.3 to .9 to 1.2 to 1.0 i wonder if those were actual reading errors or maybe change in attitude , lifestyle or diet that cause those fluctuations
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There are several posts on LVH of people like us (borderline) if you do a medhelp search and look at the archives.   I couldn't find that one exactly but found this one from someone.

-----------------------------------
I have had 3 echos over a 20 year period.  



First Echo: LV Posterior Wall = 8mm, IVS = 7mm

Second Echo: LV Posterior Wall = 11mm, IVS = 11mm

Third Echo: LV Posterior Wall = 9.5mm, IVS= 8.8mm



My point is that the reported figures can vary significantly as this is not an accurate means of measuring wall thickness.  So many factors can lead to error based upon my readings. I may be wrong, but I thought it took years of high blood pressure before you got thickening.  I always present with high blood pressure when I see the doctor (white coat syndrome) and based upon my second echo my cardiologist told me I had thickening due to high blood pressure and I was put on high blood pressure medications. In actual fact my resting blood pressure when I am at home is 105/60.  My regular doctor took me off the high blood pressure medications and many years later when I had the third echo you can see that his decision was justified.  I would recommend that you have another echo at some point to really see if you have thickening.  If you do have high blood pressure then eventually it will lead to thickening so it is best to treat it now.
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