Finding on my stress echocardiogram, should I see a Cardiologist?

A year ago my PCP ordered a stress echocardiogram because I was complaining of occasional dizziness and heart palpations.

It wasnt until I was turned down by three private health insurance companies and contacted the MIB about my personal record that I finally got a copy of this report from my PCP. My doctor had told me a year ago that the test was normal. However an agency for my life insurance reported it as "borderline" after receiving the medical records.

The conclusion of the Stress Echocardiogram was that it was normal, no arrythmias, but recommended a 2D echo with doppler to investaigate the following:
"MV appears to be myxomatous and interartrial septum is thinned and appears to be aneurysmal."

I looked up these terms which are confusing to the lay person. I dont know if I should be concerned since my PCP never ordered the recommended test. And what does all that medical terminology mean, could something be wrong with my heart, and if so, how serious could it be now or in the future?


This discussion is related to aneurysmal interatrial septum.

[vienna13]

"never ordered the recommended test" ...he is a doctor he doesnt think you need it for now.

Eat right, sleep right, don’t smoke, exercise the best you can do for your heart.
No one has knowledge of the future, but we all have better outcome if we live right: heart friendly instead of worrying.  
          

[kenkeith]

I'm not sure I understand the chronology of tests, opinions, etc.  And the doctor stated test was normal, but the insurance company reviewed the same data as the doctor and stated reults were "borderline"?  The stress test was normal, but recommended doppler?  There must have been a doppler test as the quote in your post of a result "MV appears to be..." .  A doppler shows blood flow through the heart just a stress test does not.

For a perspective, a myxomatous mitral valve (MV) is characterized by an enlarged, thickened, floppy leaflets (covers valve opening to prevent backflow) and an elongated chords (chord is attached to leaflet and heart wall).  Not sure what borderline means in this context?  Usually refered to as mild to severe regurgitation (leakage) depending on how well the leaflets cover the orifice.

Interatrial septum (wall between right and left atria (upper heart chambers).  The report states the wall is thin and subject to an aneurysm (bulge that can ruture) if serious and not treated.  Also, the right atria is the source for electrical impulses for the heartbeat, and the septum is a pathway for electrical impulses.  An obstruction of the pathway can cause a rhythm problem.

You should get a clarification to the differing opinions, and if you have an aneurysm, you probably shouldn't get involved in any rigorous activity as an increase in pressures from exertion can rupture an aneurysm.

I have provided the worst case scenario and yes it can be serious and progress if not properly treated.  Get another opinion if necessary.

[Smiley2000]

Amanda/Kenkeith

oh my gosh, it sounded as if Kenkeith was talking to me!  I have a Mitral Valve floppy valve with mild regurg and a ASA (Interatrial Septul Aneurysm).  My Cardiologist discovered this with an Echo and did a TEE to confirm it.  I have been put on ECUTRIN, which is something to thin the blood to prevent bloodclots from forming there.  I have 6-monthly checkups to monitor aneurysm and valve leak.  I also have permanent arrthythmia - PVC's/PAC's and have tried 4 different Beta-blockers, but they only lower my BP even more and then the pauses between the skipps are to long.  Had Ablation done that cured PSVT.  Had tilt test done that showed fluctuating BP and palpitations and PVC's.

"right atria is the source for electrical impulses for the heartbeat, and the septum is a pathway for electrical impulses.  An obstruction of the pathway can cause a rhythm problem."  

Do you think that is why I can't get my rhythm under control?

For the past 2 months I have been getting these burning pains in my chest area (just a little bit off-center to the left) when I am at rest.  Can this be due to the PVC's or Aneurysm?

Amanda, you must have regular checkups (at least 6monthly or annually) to monitor your Aneurysm and valve.  And you must drink meds to help prevent blood clots.  

You can not just ignore it.

[kenkeith]

" Although the precise relationships between arrhythmia and ASA are not yet known, one could suggest that this organic anomaly is susceptible of originating and of maintaining the arrhythmia longer, if not in a more severe fashion,. Further studies are necessary for a better understanding of the meaning and mechanism of such an association"....  I was / am suggesting the morphological characteristics of an aneurysm to heart wall and septum has or may have a physiological effect on electrical impulses just as thickening, dilation and enlarging of the septal and heart wall does although the etiology or pathogenesis to the electrical impulse channels may or may not differ.  Doesn't that make sense?

Résumé / Abstract
Atrial septal aneurysm has been associated with thromboembolic events, interatrial shunting, mitral valve prolapse, and systolic click. An association between atrial septal aneurysm and cardiac arrhythmias has been also described. Twenty patients with atrial septal aneurysm and 19 control subjects performed 24-h Holter monitoring. Frequent (>10/h) atrial premature beats were observed in seven patients vs. none of the controls (P = 0.008). The mean number of episodes of supraventricular tachycardia and the prevalence of ventricular tachycardia were also higher in the atrial septal aneurysm group (P = 0.044 and P = 0.046, respectively). Left atrial enlargement, mitral valve prolapse and left ventricular hypertrophy were more frequent than in the normal subjects. In conclusion, atrial and ventricular 'complex' arrhythmias occurred more frequently in patients with atrial septal aneurysm than in normal subjects. Further studies in patients with atrial septal aneurysm without other associated echocardiographic abnormalities need to be done to ascertain a potential arrhythmogenicity of this condition.
Revue / Journal Title
International journal of cardiology  (Int. j. cardiol.)  ISSN 0167-5273   CODEN IJCDD5  

[Smiley2000]

Thank you soooooooo much.  I have found the "link" where the above info came from, made a printout and I am going to ask my Cardiologist about this.  I have been up since 02h10 this morning with a burning chest, 18 miss beats per minute (that woke me up) and a jaw that aches!

I am just praying that it is not the ASA that is causing all my symptoms cause I don't want to know what they have to do to fix the problem!

anyway, have a great Friday and an even greater weekend.

[kenkeith]

You're welcome, hope it works out for you.