Echocardiogram Results

[DT66]

I have a 16 year daughter that went in for a routine physical with a new dr.  The dr. heard a murmur (although I thought later is  was maybe due to the extreme anxiety my daughter was feeling over the new dr. mentioning a possible thyroid problem because she has big eyes (and always has) and blood that was about to be taken). Is that possible?  No dr. had ever mentioned a possible murmur.

The blood work all came back normal including the thyroid so the dr. ordered echo. to check out the murmur.  The echo report came back good except for the mention of aortic root dilatation which I have been worried about ever since.  We are waiting to see the pediatric cardiologist, but that is weeks away.  

Pediatric Echo:
170.18 cm / 51.7 kg BSA = 1.56
Findings:  Nothing abnormal noted, except: trace physiologic tricuspid regurg. present, trace pulmonary valve regurg. present and  aortic root dilatation

Conclusion:
Normal ventricular function
aortic root dilatation
trace mitral regurgitation.

M-mode measurements that was listed out of normal range was:  
AO Diam: 31mm
Other M-mode measurements:
IVS % Thick: 66.67%
LVPW% Thick: 28.57%
IVS/LVPW Ratio: .86
LVEF: 63.27%
LVFS: 34.09%
LVMass Corr.: 83.21g
LV Mass Index: 57.8 g/m2
LVM/Ht^2.7: 27.06 g/cm
RWT: .3

2-D measurements
PV Annulus: 21mm
MPA Diam: 19 mm
RPA Diam. Sys: 9mm
LPA Diam Sys: 9mm
AV Annulus:  22mm
Sinus of Valsalva: 24mm
AO ST Jnct Diam: 28 mm
Trans. Aorta: 11mm
Isthmus: 12mm
Desc. Aorta: 10mm

She has always been very healthy and rarely sick.  Her blood work is normal including thyroid.   She has taken Doxycyl. - 1 capsule a day for about 3 years for acne.  She took adderall xr 15 mg for approximately 1 1/2 years, but stopped about 8 months ago b/c she didn't like the side effects.  (Obviously, the doctor missed something or something wasn't there b/c she shouldn't have ever been taking adderall if there was a possible problem).  We have no family history of marfan, I’ve checked the marfan website and she doesn’t have 4 of the 8 skeletal features (she has 2: long arms that run in my family & flat feet that all my kids have); other than that, she is near sighted as is the rest of the family.  Any other less life threatening possible causes to an aortic root dilatation other than marfan?

Also could these test be affected anyway by the technician doing the test?  At the end of the test she kept getting phone calls and all.  I don’t think she was measuring anything though.  Or does the radiologist do the measuring when viewing the echo.?

If you could shed any light on this report I would greatly appreciate it.

[rdstoltzjr]

Hi,

I really do not think you have anything to worry about the murmur at this time. I had a similar murmur at age 20, it was called a harsh systolic murmur at the aortic root.  I never had any symptons or problems, but subsequent echo cardigrams  showed the progression from a nild murmur, to moderate mumumur to now severe murmur.  The dimension of the valve is important to follow, less than   1 cn, is where the concern appears to be.  over the last ten years mine went from l.2 to l cm. I am now 77 years old, and my cardiologist informed me as long as I don't have any synmptons, fainting, shortness of breath,chest pain not to worry or do anything.  If I do develop any symp-tons, drugs or surgury may be required.  Your daughter has many years to live normally before she needs to worrry, in my opinion.

[Encephalomalcia]

Heart murmurs can be heard by the doctor and during the echocardiogram.  Heart murmur is an abnormal sound cause by the abnormal heart valves.  Adderall could have caused this.  Goggle Adderall +heart disease and it will pull up lots of information linking the two together.