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Echo questions and LVH diagnosis
I posted this bottom question yesterday, but so far nobody has responded.  I had another question about the echo which was taken in the cardiologist's office.  Is it normal for the technician to ask me to talk while taking the echo?  I've never had one before and was very nervous.   She had me lay on the flat, uncomfortable table.  I have a very bad back and that was pretty bad.   Then she immediately asked me to turn over and face the wall.  The table was barely as wide as my hips, so this was bad.  She put the ultrasound probe under my breasts as soon as I turned.  I didn't get a chance to catch my breath or relax.  I was breathing pretty strongly and just nervous overall.  The she starts asking me all types of questions about my life.  I answered her but thought it probably wasn't the best thing to be talking during a heart echo.  Anybody else asked to talk during or not given a chance to relax?  Did that effect my echo test?  Next....

I just had an appt with a cardiologist on Thursday.  I have never seen one, but am on bp medicine Toprol XL 25 mg twice a day for 3.5 years.  I made a mistake by stopping my nighttime dose two months ago.  Readings were normal until three weeks ago when I experienced major stress over a family member.  It seems that kicked me into withdrawal.  I had an EKG at my local doctor's office and he said it was basically normal.  I decided to see a cardiologist after I started taking my nighttime does again, but have been having spikes.  He did an EKG also, and nurse said it was normal.  But he wanted to do an Echo.  Doctor came in and mentioned that I had hypertrophy and said some number like 1.3?  He suggested I switch from Toprol to Bystolic 10 mg.  I called the nurse the next day after coming home to research hypertrophic.  She said my echo was 'good' and used the word normal.  I asked if I had LVH and she said yes.  Then she said, "Everybody has LVH to some degree."  She said I was at 1.2 .  I asked if he saw anything else on the echo, like leaking etc.  She said no and if he had, he would have told me.  

The next day I received the report which I had asked to be mailed to me.  I was upset to see that my IVSd was actually 1.4 cm. It also said I had a moderate concentric left ventricular hypertrophy with a dilated left atrium.  Also have regurgitation.  Why would the nurse use the words normal and good.  Why did the doctor mention 1.3 or 1.2.  I didn't see those numbers anywhere on the report.  The cardiologist also said that it was 'impossible' for somebody my age (42) to have a heart attack.  Is he crazy?  How serious is this?  I plan on starting the Bystolic on Sunday.  I am not sure when this damage happened but my bp was wonderful and low the whole 3.5 years I've been on the Toprol.  Not until 2 months ago that I halved my does has it been erratic.  Doctor said that there is no way this happened in the last two months.  I am depressed over this.  Also I wonder if stopping the Toprol XL cold turkey an while starting a new medicine will cause problems?
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159619 tn?1318997813
First off, talking during an echo won't really affect it. Your wall dimension is on the high side of normal (1.2) to 1.4 slightly abnormal but both are within a normal variant. Also, a dilated left atrium is not normally of much consequence. An echo is not always a good measurement for atrium size. These readings are open to interpretation so if you were told your test is normal I wouldn't second guess them.

Jon
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