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Echocardiogram results
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Echocardiogram results

My results for my echocardiogram were Mild LV diastolic dysfunction and Mild MR and mild TR.  My dr explained nothing much except that it is probably from uncontrolled high blood pressure due to renal artery stenosis. I'm worried, but he told me to see a nephrologist for the RAS to get the bp under control.  Can anyone help?  What does MR and TR stand for?  It doesn't explain it in the report.
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976897_tn?1379171202
I think the V has been missed in both cases, as in TVR and MVR.
Tricuspid Valve Regurgitation / Mitral Valve Regurgitation.
Both valves have a slight leak, and this is absolutely nothing to be concerned about. Most of the population have slight leaks in heart valves, enough people to really class it as normal.
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367994_tn?1304957193
Q: "My results for my echocardiogram were Mild LV diastolic dysfunction and Mild MR and mild TR.  My dr explained nothing much except that it is probably from uncontrolled high blood pressure due to renal artery stenosis. I'm worried, but he told me to see a nephrologist for the RAS to get the bp under control.  Can anyone help?  What does MR and TR stand for?  It doesn't explain it in the report".

As stated the classsification of mild, trace, etc referring to the heart valves have very little medical significance if any.

However, the mild LV diastolic dysfunction may be the result of high blood pressure!  For a perspective when the heart beats against higher than normal resistance (cause for high bp) the heart walls will thicken.  When the walls thicken there will be some rigidiity and the filling phase (diastolic) of the heartbeat cycle will be effected and less blood will be pumped into circulation with each stroke.  It appears you have a mild condition that may limit the amount of blood pumped (systolic) with each heartbeat.

The RAS maybe the underlying cause for the high blood pressure and the high blood pressure may be the underlying cause for the diastolic dysfunction. Treatment can prevent any progression of diastolic function.

Thanks for your question, and if you have any further questions or comments you are welcome to respond. Take care and I wish you well going forward.

Ken
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159619_tn?1318997813
Mild LV diastolic dysfunction is becoming a very common finding in echos these days. I had one in 2006 that showed the same thing and my doctor explained that it was a very common finding recently due to some new guidelines for conducting echos. In any case, I had an echo again a year later and there was no mention of it. It's usually due to the heart's inability to relax in the diastolic portion of the heartbeat and fill properly. As Ken said, thickened walls in the LV would cause that, but f your echo did not show that then it's most likely due to increased internal pressures and once your BP is controlled it will most likely go away.

Hope this helps,

Jon
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367994_tn?1304957193
Q: ...your echo did not show that then it's most likely due to increased internal pressures and once your BP is controlled it will most likely go away.

A:  Jon, I don't quite understand!  Apparently, the echo did/does measure heart wall dimensions and those dimensions are outside the normal range. However, there is a margin of error as the dimensions borders are somewhat difficult to determine.  The borders of a pumping heart are fuzzy and the tech uses a transducer in an attempt to outline the border.  Ths faster the heart beats the more likely a higher margin of error.  

The wall thickenss can be pathological or non-patholigical  The difference is due to the myocyte cells.  The heart tissues have specalized myocyte cells that have an elasticity feature. Pathological myocyte cells increase and line up side by side to increase wall dimension and there is some loss of elasticity.  A non-pathological myocyte cells increase the wall dimension by elongating  the elasticity of the cells.  The difference is the elongating cells have stronger contractions (frank/starling law of physics) and there is an increase of cardiac output with each stroke during rest (<60 bpm).  Also, when rigorous physical exertion has been decreased over a period of time the heart walls will return to normal.  

Pathological myocyte cells often do not return to normal.  Pumping against high resistance (high blood pressure) the heart wall size is increased due to the additional burden for the heart. System blood pressure management can prevent any progression.
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159619_tn?1318997813
A:  Jon, I don't quite understand!  Apparently, the echo did/does measure heart wall dimensions and those dimensions are outside the normal range.

I am confused, I don't read that in this post. Where are the dimensions mentioned? I am fully aware what an echo measures, I just don't see any mention of wall or chamber measurements. I had diastolic dysfunction with normal measurements, that's what I was basing my response on.

If I'm missing something here, let me know.
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976897_tn?1379171202
My 2 cent worth. I think Kenkeith means the LV dysfunction being related to high blood pressure and existing, rather than being something to do with the guidelines now in echo scanning?

"My dr explained nothing much except that it is probably from uncontrolled high blood pressure due to renal artery stenosis"

Just my 2 cents.
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367994_tn?1304957193
It appears hpb with an underlying cause being RAS. DD would/could cause some intra ventricular pressure and that would/could cause a possible left atrium enlargement.  But that pressure would be distinquished from system pressure and the system pressure can/will  cause heart wall thickening.  The post does not list any numerical values...just results,

It is true there is no mention of wall dimensions but an echo takes the measurement and the results are computed by the software....dd was the echo output and possible diagnosis. How else would DD be diagnosed?  The echo report would/should show the wall dimensions, chamber size, heart valve sufficiency or lack thereof, ejection fraction, heart wall movement (hypokinesis?), and gradient pressures,etc.

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159619_tn?1318997813
From my echo in 2006;

1. Preserved ventricular function, EF 55% - 65% without focal wall motion abnormalities. LVH was not identified.

2. LA, LR, LV, RV of normal size within normal ranges.

3. Mild diastolic dysfunction on trace mitral valve insufficiency.

4. Trace tricuspid valve insufficiency.

5. Pulmonary artery pressures by Doppler estimated at < 30 mmHg, within normal limits.

Overall assessment; normal echocardiogram with mild diastolic dysfunction.

So based on your thinking, how was mine diagnosed? There is no mention of any of  the issues concerning camber/wall size. In discussing this with my cardiologist, she said it was detected by the outflow pattern as seen on the Doppler and was reported because it was seen by the tech, even though everything was within normal limits it had to be listed. On my echo the following year there was no mention of any of this.
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976897_tn?1379171202
Can they see on the image whether the chamber is relaxing as it should do? uniformly? or at the right rate? I would have thought this would be an observation which looks quite obvious? Regardless of any other information I would have thought that a tech with a lot of experience would visually pick such things up very quickly?
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367994_tn?1304957193
Ed, good question, there is what is called fractional shortening.  That is similar to ejection fraction, but the difference is FS is an estimate regarding a ratio of wall dimensions and EF is estimate based on volume differentials

From the echo report dimensions, the FS equation is LV end diastolic dimension (peak volume after filling) and from that there is the subtraction of LV end systolic dimension (least volume in chamber after pumping phase) and from that the difference is divided by LV end diastolic dimension giving the fraction for FS. Normal range is 18 to 42%, above 30% is considered normal.

I did my FS in 2004 from the dimensions shown on the echo report.  It was 6.2 - 5.2 = 1.0 divided by 6.2 =  16%. Increasing the difference between end systolic and end systolic increases FS.  The greater the difference (more compliant is the relaxation of the left ventricle) the higher is FS.

I agree, heart wall movement disorder (hypokensis) as an example would visably be seen as well, etc.  .

>>>>Jon, you had a doppler test and that is the software to evaluate blood flow through the heart. A comment by the tech may cause attention and cannot be dismissed according to the report. My color doppler study showed severe MVR and moderate tricuspid and aortic consistent to blood flow analysis. It is the M-Mode, 2D echo that showed dimensions. etc.

I don't know what the tech saw or there can be a flow pattern that is similar to hypertrophy cardiomyopathy?, but it would require a M-Mode, 2D echo to verify DD based on dimensions.

OP had an echo.  
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159619_tn?1318997813
Ken,

My report shows both. I had an echocardiogram along with Doppler imaging.
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367994_tn?1304957193
Jon, I have had both at the same time also, several times.  Monitor MVR with doppler and heart enlargement with M-Mode echo. I always ask for a copy. Take care,

Ken
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