From borderline LVH to mild LVH

[tickertock]

Thanks for taking my ?? I had an echo done nearly 5 years ago , it showed only borderline hypertrophy, I had a echo done this past Tuesday which the cardio said had progressed from borderline to mild, a change of about 2mm if I remember correctly, B/P was 140/85 in the doc's office, at home every time I take it is always control around 115/70 most of the time. He said that from the blood vessel in my eyes , it showed that my B/P needed more aggressive treatment, He up my cozaar from 50mg daily to 50mg x2 daily and added hydrochlorothiazide 12.5mg, I also take 100mg of atenolol daily in divided doses, he said that is a good way to take atenolol because it is not as long acting as thought.

I have a connective tissue disease that can affect the heart valves thats mainly why i had the echo, he said my valves are perfect , no leaks , no obstruction whatsoever and that my heart relaxes perfect despite the mild LVH, in fact this time he seemed less concerned than he did 5 years ago, in fact 5 years ago to be honest he almost alarmed me about the borderline hypertrophy, now he seems to think that with weight lost , 25-30 lbs overweight and more aggressive B/P control, I have nothing to worry about. My ejection fraction was 55% at lowest estimation, last time it was 64- 75%, though I was much more nervous at that time. I was kinda of concerned about the drop, he said that was perfect and not to worry.

At what measurements are LVH a clear concern? If my B/P is controlled at home why is the LVH progressing if even by 2mm in 5 years? I don't want to overmedicate. Thanks.

[CCF-M.D.-MJM]

Hi Tickertoc,

congrats on the weight loss.  that is great!!


At what measurements are LVH a clear concern?

LVH is defined as a interventricular septum greater than 1.2 cm.  Significant risk starts at about 2.0 cm -- this usually reflects some significant hypertension, hypertrophic cardiomyopathy, amyloidosis, and a long list of other problems.  It is important to remember that this is a continuum and there is no single cut off value though.

If my B/P is controlled at home why is the LVH progressing if even by 2mm in 5 years?

We think LVH is caused by hypertension and hypertension is certainly something that we can try to control.  there may be other causes but they are not easily recognized and treated.

Hope this helps.

[tickertock]

Thanks for the quick reply, last time my interventricular septum was 12mm ( I think that equal 1.2 cm, this time it was 14mm, I think that is equal to 1.4cm) that is the only measurement I think that was a bit above normal, also I understand it could be a 1-2 mm error in interpretation at times, regardless apparently the error is usually not significant and often err on the side of caution.

I actually am overweight by 25-30lbs, but working on losing it in a period of couple months, sorry if gave the impression that I had lost weight, but I'm starting to work hard at it. Thanks again for you quick answer it was much appreciated.

[tickertock]

Anyone out there diagnosed with mild left ventricular hypertrophy and told not to worry. Any comments would be appreciated. Thanks.

[LacyMary]

I was diagnosed with LVOT after a stint with A-FIB and told not to worry. This showed up on an Echo 2 weeks after being converted back to NSR.  But, they are doing Echo's every month now on me.

[tickertock]

Was your diagnosis LVOT VT or LVH? Thanks. LVOT is left ventricular outflow tract ventricular tachycardia, LVH is left ventricular hypertrophy since it was by echo I assume it was LVH. Thanks again.

[Michaelccc]

are you still watching this forum?

[tickertock]

Rarely as much , drop in once in awhile, the dates same to be mixed up , can't follow it much anymore.Hope you're keeping well.

[Michaelccc]

reason i'm asking is because i'm going through a similar situation. i'm 35 years old very very slightly overweight. no drinking no alcohol but lots and lots of smoking. i had an echo done a month ago to rule out possilbe lvh and other stuff by a cardio and she told me echo was fine. last week i decided to get another opinion to make sure my heart is fine because i still keep getting some pvcs. not many but a few here and there. anyway second cardio wanted to get echo that i did a month ago. i picked it up from the first cardio and i noticed it sayd 1.4 mm for ivs and posterior it also said "mild lvh"  first cardio said normal echo. i showed this report to the second  cardio and he also said the same thing . don't worry it's normal. im' very confused as you seemed to be in your posts here. so what do i make of this? is this a progressive situation? how did yours work out? did it progress again? did you find out what makes it progress or how to regress it?

[Momto3]

Hello

There is a link on the forum to change the dates to appear in "date posted" order or "date of last post."  Maybe that's why your dates are mixed up.  

Hope you are well : )

[tickertock]

Never had it checked in 2 years(2005), my IVS was 14mm and posterior was it was 10mm I think, other echo was 6 years ago(2001) where 2 different frames on the same echo measured the IVS at 10mm-12mm.

It was blamed on mild HTN(hypertension which is now very I'm still about 30-35 lbs overweight)I also have a ankylosing spondylitis which is no fun.

I questioned the cardio and he was not concerned , sometimes I think the measurements can be 1-2mm off. I don't if it has progessed or not though my last ecg was not suggestive of LVH, a few other previous ones were, though its not the gold standard.

If your doc is not concerned don't be I was advised to check it every 2 years, once they tell you 2 years then I don't think itrs too concerning, I'll wait another year because my HTN is controlled and I rarely have palps anymore.I never did smoke , which is plus but I do drink a few more beers than I should but you can enjoy life with over indulging, but I would advise anyone who who smokes to stop, its the worst thing you can do for your health. Good luck.

[tickertock]

Should have wrote you can enjoy life without over indulging, and that my hypertension is well controlled. Sorry , my head gets ahead of my one finger typing at times :)

[tickertock]

Everything is ok as it can be in my case with AS. Thanks for asking and I hope you're doing well also.

[Michaelccc]

oops messed up my numbers there. i should say the echo from a month ago shows. IVS at 1.2 and posterior at 1.2 as well.  ekgs obviously all state possible lvh. i'm just so confused as to why the first cardio that ordered the echo in the first place said echo is fine and no lvh. as far as i see from posts here 1.2 means mild lvh. so anyway i'm curious here. when yours came back as mild lvh years ago. did your ekg's also state possible lvh as well as echos? because i see that your ekgs no longer state possible lvh which most likely means no lvh. so it basically regresssed? how did you do it? and any idea why a cardio would not mention a "mild lvh" to me? is 1.2 not considered lvh?

[Momto3]

I'm so sorry your AS is giving you trouble.  Does it tend to wax and wane also?  I'm not real familiar with the specifics of AS, but I do know it has given you a real run for your money.  

A couple of months ago, I was walking the dog and we side-stepped to avoid a jogger.  I ended up tripping over the dog and slammed my right ribs onto the concrete.  Man, that hurt!!  Anyway, my costochrondritis flared up BIG time.  Is AS similar in that the pain intensity fluctuates?  It has been about 10 weeks, and I can finally sneeze without too much pain.  

Other than that, I am doing pretty well. My pvcs have been a bit more active, but still very, very tolerable compared to before. The valve appears to be stable and I'm hoping to keep it that way.  
.
Take care and stay cool!

connie

[tickertock]

[tickertock]

Micheal : 1.2 cm of the IVS  and posterior wall would be the upper limits of normal and probably be decsribed as marginal/borderline LVH, could be completely normal for you, your cardio could best tell you that , sometime minor insignificant findings are not told to a patient especially anxious ones as to avoid further anxiety( It's not warranted, but the patient deserves to know regardless), only 1 or 2 ecg of mine was suggestive of LVH for and that was in 2001, all other ones since have been printed out as completely normal. There are many false positives on ECG for LVH, the echo is the gold standard.Don't stress yourself, you're probably all within the normal limits and having nothing to worry about. Be well.

Connie; I'm sorry to hear about your fall, I had costo since 1994 before I even knew I had AS its frightening and very painful. My AS tends to flare and wax & wane, but I'm never a day without pain and stiffness all over,the key is never give up or give in and keep moving regardless.
It's hot here for sure and the heart of hurricane season is approaching so far so good but we have severe weather building up around us right now that the NHC is watching.I hope your PVcs keep at bay, mine have been real quiet now for over 5 years (knock on wood). Thanks for caring, hope you feel better and keep well.

[ozy]

A related discussion, just heard was started.