Echocardiogram Re

40 year old woman, non-smoker.  PVCs PACs since I was a teenager, multiple Holter monitors and echos.  Palpitations are not frequent, but feel like a skipped beat/heart stopping for a split second and sometimes send a "shock like" jolt through my entire body followed by mild HA.  Always told the PVCs PACs were of no concern.  Some drs would diagnose me with MVP, others would say that I didn't have it.  Health history is Hashimotos thyroiditis and anxiety/panic attacks.  Recent cholesterol levels normal.  Blood pressure typically runs 120/80 or lower .. however, it does spike when I have anxiety attacks and I have white coat HTN (BP high as 160/90's in the office).  I am a nurse so I do monitor the BP at home. My health insurance situation changed, so new doctor and new echo as follows:

RV internal:  21mm
IVS:  10 mm
LV Internal (S):  25 mm
LV Internal (D):  45  mm
EF:  74%
LVPW thickness:  12 mm
Left Atrium:  37 mm
Aortic Root:  28 mm
Aortic Valve Excursion:  19 mm

LV:  LV with thick walls.  Normal LV systolic function.  The EF is 74%.  No segmental wall motion abnormalities.  Normal thickening of all segments in systole.
Mitral valve:  elongated leaflets.  The anterior leaflet briefly touches the interventricular septum.  No left ventricular outflow tract obstruction.  Gradient of 2.1 mmHg.  No evidence of prolapse demonstrated in any of the views.  Diastolic flow through the mitral valve is normal.
Tricuspid valve:  Moderate regurgitation.  No pulmonary hyptertension.
Pulmonic valve:  Mild pulmonic regurgitation.

LVH is new as is "elongated" MV leaflets.  Does this mean I have HCM????

My father passed away at age 57 & I do know he had HTN starting in his 30's and smoked. In 40s, developed endocarditis & subsequent CVA. Theory was he had an "undiagnosed" valve problem & recently had dental work then developed endocarditis.  I know cause of death was listed as "cardiomyopathy", however it did not specify which type (and yes, he had CAD).

Thank you.

[daisy2004]

Also, the results state "concentric LVH with good left ventricular systolic function"

Thank you for your time.

[tickertock]

I'm not a doctor but your echo finding are essentially normal with only mild LVH of the LVPW(d) , my numbers years ago(2001) were the opposite of yours 12mmIVS, and 10mm LVPW, in 2005 the IVS was 14mm and the LVPW was at 10 mm,I was still assured I don't have HCM, I never had an echo in over 5 years I refused to worry about it, a recent study showed that patients diagnosed with HCM a wall thickness< or = to 15mm had benign diagnosis, and 16mm to 19 mm were on par with arrhythmic events in the normal population , basically the same as 15mm and below, just keep your BP under controll, this is very common finding in patients without HCM, don't burden yourself with worry!

[Cleveland Clinic]

12 mm on the posterior wall is just passed the upper limit of normal so I wouldn't jump into diagnosing you with hypertrophic cardiomyopathy, but I would repeat the echo in a year to make sure that there isn't worsening LVH.  The leaflet alone doesn't cause any obstruction, and typically with HOCM the septum has to be thicker and the leaflet elongated and they touch each other during ejection causing a significant gradient.  You don't have that, but again, it needs to be followed with subsequent echos.  You may have early stages of HCM but there isn't any way to tell it now.  I think it's very imporatnt to keep you blood pressure under good control because that may be stimulus for your mild ventricular wall thickening.  

[daisy2004]

Thank you for responding.  I forgot to ask ... since this echo did not show a prolapse mitral valve, but an elongated leaflet, should I still be taking antibiotics prior to dental appointments??
Thanks.