Echo report

[AudreyRose]

Happy Holidays.

For almost 2 years now I have an Echo because of LVOT fondings with a small gradient 30-36.  Then the past three echo's show the words, "Diastology Impaired".  I asked about this and was told I had Diastolic Dysfunction and not to worry about it.  Last week I had my 6 month echo and now it shows next to Diastology, "LV Relaxation is severely impaired".  At the top of this Echo report it states: Quality of Echo...Technically Difficult. Am I difficult?
Also, next to Mitral Valve it states: "Not well seen. There may be SAM of the valve or chordae. Moderate annular calcification.  Mild Calcification of the leaflet"
Dr. I am a woman in my sixites.  I have 4 DESstents (2004)  I have good BP.  MY EF states: Hyperdynamic >70% (this seen on all echo reports)  My BNP is 30 and below.  I do have swollen ankles and feet and at times have a hard time breathing.
I always have the Echo in the same large Cardiology group but with 5 different doctor's in the group reading them. (thye take turns)
I am thinking of going elswhere for answers as I am concerend about this new report and the LV Relaxation noted as severely impaired.  Can you elaborate on this?  I feel I must take charge and help myself. Thank You.

[Cleveland Clinic]

Severely impaired LV relaxation refers to the diastolic function of the heart.  The fact that it is abnormal could potentially explain why you have swelling in the legs.  The fact that your BNP is less than 30, however, argues against that.  I would think that you in this situation one should focus on other causes of lower extremity swelling such as poorly controlled blood pressure, liver or kidney disease, abdominal disease, etc.  Also, coronary artery disease can cause abnormalities of ventricular relaxation and should be ruled out as a possibility.  Since you have had stents placed in aleady, they may need to be reassessed with a stress test.  Finally, based on the echo it doesn't seem that there is any valvular disease, however, I am concerned about the LVOT obstruction.  A technically difficult study just means that you are not very echogenic.  Most of the time it has to do with obesity, but there are many patients who are thin who aren't echogenic.  An MRI is a more definitive test in that situation as long as one does not have a pacemaker or a defibrillator or any other metal parts in their body.

[AudreyRose]

Thanks so much. I will ask for the Cardiac MRI.  One doctor wanted this (Interventionalist) months ago but the female Cardio in the group said No.  I have a high PTH reading and no Vitamin D also.  Calcium levels are normal so I am a puzzle.  I am not overweight...well perhaps 15 lbs. No metal in my body for a MRI.  Thanks much. Audrey