Echocardiogram Results

[Mishanko]

I hope I asking this question in the correct place. I am   29year old female. Athletic. Runner (3miles a day). had normal stress test, and EKG. Here are my echo results:

LV = everything normal

RV = upper normal in size. Performance is normal

LA = volume mildly increased.

RA - Mild to moderately dilated. Atrial septum aneurysmal, with shunting only upon cough. Doc thinks it could have been my lung expanding as well and has indicated no reason for blood thinners.

Mitral valve = Normal - No MVP - No stenosis - trace regurg.

Tricuspid Valve = Normal - trace regurg. Peak Right Vent. Systolic pressure = 25mm Hg plus

clinical estimation of right atrial pressure

Aortic valve - Normal, no stenosis, trace regurg.

Pulmonic valve - Normal, No stenosis, No regurg.

Aortic root - nonrmal

Pulmonary Artery - mildly dilated

FS = 37%

I had 2 echos done at 2 different hospitals. The hospital here at home did not recognize any regurg. and they also did not recognize the RA being dilated, or the LA volume increase.They stated my EF was 60%

Ok, I am confused about the RVSP being 25 mmHg. Is that normal? Also the trace regurg's. Are these normal?

I also don't get the right side of my heart being dilated. Plus the pulmonary artery being dilated. Should I be concerned with Pulmonary Hypertension?

Could my running cause my left atrium increased volume?

Any info would be great...

Jennifer :)

[Mishanko]

Thank you for answering my questions. This makes me feel better. My cardiologist had stated that he was not sure if the shunting was actually my lung expanding or an actual shunt. So, he had stated that if I wanted to I could take a baby aspirin. But, he did not say that it was recommended due to my age and that I am a woman. So, I take fish oil and thats about it. I have thought about taking a baby aspirin as well.

My cardiologist here at home told me not to worry about it and to wait until I had symptoms. I laughed and thought," wait till I have a stoke and then get treatment?" So, I went up to University of Chicago and they were telling me that they would do the bubble study to see about shunting. My results showed possible shunting while coughing but he thought it was my lung expanding. So, I am unsure as well. I have a follow up with him in January. I guess I will address the issue then.

Jennifer :)

[Cleveland Clinic]

The only thing that strikes me as being abnormal in your echocardiogram is the atrial septal aneurysm with likely patent foramen ovale and shunting ( right to left) with coughing. This is important if you ever develop a stroke or TIA, as these have been implicated in the causation of CVAs. Trace valve regurgitation are normal findings as is an RVSP of 25 mm Hg. An echocardiogram is not the best test to evaluate the pulmonary artery, as the main PA is usually not seen in its axial dimension as it would be on a CT scan. No concern for pulmonary hypertension because your RVSP ( surrogate for pulmonic pressures) is 25 which is normal.
The LA volume is once again not a very reliable index measured by echocardiogram as the left atrium is very eccentrically shaped and positioned deep in the chest. Additionally, some people make the mistake of including the LA appendage into the calculation, which gives erroneously elevated volumes.

[Mishanko]

I also meant to say that I have Hashimotos Hypothyroidism that is still not controlled. My last TSH was 5.99. I take 150 mcg of Synthroid.

Jennifer :)