Echocardiography results

[jeliz]

I had a stress echo done, then a cardiac catheterization. The impressions from the echo were: The ejection fraction is 68%, which I know is great. Grade I diastolic filling pattern indicates impaired relaxation. The left atrium is mildly dilated. The study was abnormal with 6/10 chest pain which limited exertions. In response to exercise, the ECG showed borderline ischemic changes. The mid anterior wall was difficult to visualize, but seems to show mildly hypokinetic wall motion. Rare premature ventricular contractions were noted during exercise.

I have shortness of breath and chest pain with some faintness with exertion, which the doc was concerned about until he did the catheterization. When he saw that my arteries are all clear, now he says that I have no problems since I'm not at immediate risk of a heart attack from clogged arteries. Isn't there still an underlying problem with the diastasis? (I'm a sonography student). I don't want to miss a problem that we can take care of in the early stages.
Thanks, jeliz

[grendslori]

HCM can be either genetic or sporatic. My daughter had a severe concentric HCM and no one in the family (either side) has the disease. The fact that your mother has family members who all died around the age of 50 from heart attacks tends to make me really suspicious of HCM. All people belive people die suddenly from heart attacks, actually people die suddenly from cardiac arrhythmias. Chances are the family members died as a result of arrhythmias; that is the cause of death in HCM patients if they die suddenly. At that rate, I would CERTAINLY seek another doctor, try a University Hospital, and tell them about the number of early age deaths in the one side of your family.  

[jeliz]

Isn't hypertrophic cardiomyopathy a familial disorder? No one else in my immediate family has this problem. My mother's family has one branch with several members who died around age 50 with sudden heart attack, but they all also smoked. Only 1 cousin has had a major heart issue, and he has 4 blocked arteries. My father has atrial fib, so his atrium is enlarged, but he is 80.  I'm 58.

[grendslori]

There is a possibility that you may have Hypertrophic Cardiomyopathy which would explain the relaxation problem along with the enlarged atrium. It would also explain the ischemia patterns. I wouldn't let the doctor dismiss this, he he continues to do that, I would certainly look for another doctor!