Echocardiagram results help understanding

[cldubsokind]

  I can not get ahold of my cardiologist until moneday and I really am stressed about what this means for me.
I am a 33 female who is undergoing chemotherapy for stage 2b breast cancer diagnosed on Aug 09. I just had open heart surgery on Dec 30 to remove a large  1x5x2 cm blood clot inside my right atrium said to be in a rare spot caused by my mediport cath being to far inside of heart and causing friction on the wall and my chemo drugs pouring right onto it. It became this size in 1 1/2 months! I have just been diagnosed with Sjogren's Syndrom and possible Lupus. I have been having a hrad time to breathe the last week and a half so it was of concern to the docs since that was my only sign of the prior heart clot.
My searches have not given me any clear answers so I thought I would post. any help would be great good or bad thoughts welcome. Thank you Tanya G.

Preliminary report Echocardiagram performed on 2/23/2010 at CMMC cardiolgist Bender


Right Truim: The right atrium was remarkable. There was no mass present.

Aortic root: Unremarkable

Aortic Valve:  The aortic valve showed no stenosis or regurgitation.

Mitral Valve:  The mitral; valve showed some slight irregularities, but no definite prolapse.

Tricuspid valve:  There was a trace regurgitation.

Pulmonic valve:  The pulmonic valve was not well seen. There was no doppler abnormality, there was no pericardial effusion.

Pulmonary artery pressure:  RVSP (was approximately 21) with a right atrial pressure of 5. There was no pericardial  effusion.

Miscellaneous:  There appeared to be a significant calcification of the Mitral Valve Annulus.
                            This is highly reflective.
                            It seems to extend somewhat into the Left Ventricle as well as Left Atrial Wall.
                            Theer also appeared to be some calcification which appeared to be extra cardiac.

Assessment:  
    1. Normal left ventricular systolic and diastolic dysfunction.
    2. No significant valvular disease.
    3. Right atrial mass, currently normal
   4. Substantial calcification of the Mitral Valve Annulus as described above.

Mediscribe Report

LV end diastole  4.0 cm (3.5-5.6:  1.0-3.2cm/m2
LV End systole   3.3 cm
Septum                 0.7 cm  (0.7-1.2)
posterior wall       0.7 cm   (0.7-1.2) (                yes same as before )
Aortic Root          2.4 cm   (2.0-3.7)
Left atruim           2.7 cm   (1.8-4.0)  ;   1.2-2.2 m/M2       (not sure what these second numbers are hoping not measurments of the calcifications!?)
LV ejection 66% biplane

Interpretation:

Comment: the patient had a standard echo and standard esophageal echo on 11/25/2009. The overall quality of the study  was fair  and the rhythm was sinus.

Left ventricle:  The left ventricle  showed a normal systolic function with the ejection fraction of 66%. The diastolic function appeared normal including a tissue doppler E/E prime of 5.

Left atruim: appeared grossly normal

Right ventricle:  The right ventricle was unremarkable.


The wording of this concerns me. the appears to be extra cardia does that mean from another organ? what exactly is concidered significant or substantial calcification? If its extended from left ventrical to left atrial wall does that mean it is of good size? Does this always have to be repaired?  thank you for your time, Tanya

[kenkeith]

Usually when there is significant calcification of the valve orifice (opening, annulus) and  that would cause mitral valve regurgitation (backflow of blood into the atrium during the pumping phase of the lower chamber) or stenosis (narrowing of the opening.  The report indicates no mitral valve disorder. You should get clarification from your doctor!

Question: Left atruim           2.7 cm   (1.8-4.0)  ;   1.2-2.2 m/M2       (not sure what these second numbers are hoping not measurments of the calcifications!?)

>>>normal dimension of LA is (1.8-4.0).  You had two tests and both dimensions are within the normal range. Sometimes done to get verification by analysis.  


For some insight of the calcification reported: A  study tests the hypothesis that mitral annular calcium (MAC) detected by transthoracic echocardlography (TTE) is a marker for high prevalence and severity of coronary artery disease (CAD) in patients undergoing coronary angiography. Pathological studies have suggested that there is an association between MAC and calcific deposits in coronary arteries; however, there are no clinical data to support this association.
Aims Mitral annular calcification (MAC) is characterized by calcium and lipid deposition in the annular fibrosa of the mitral valve. Although individuals with MAC are at increased risk of cardiovascular events, little is known about the significance of this finding in patients with concurrent mitral valve stenosis.
Whether the degree of MAC may be a surrogate for atherosclerosis, and predict the subset of patients who will respond to statin therapy in preventing the progression of MV stenosis  remains to be determined.
Recent studies have demonstrated a significant relationship between the presence of cardiovascular risk factors and the degree of annular calcification. Individuals with MAC have a higher prevalence of coronary artery disease, arrhythmias, cerebrovascular disease, and increased cardiovascular mortality.

You have good heart pumping functionality (EF 66%, normal is 50 to 60% and indicates the amount of blood pumped with each heart beat).  And mild, trace of a valve leakage is considered medically insignificnt.