LVH and Connective Tissue Diseases

[tickertock]

Good Morning and Thanks for taking my questions.

I've been diagnosed with mild LVH of the interventricular septum, 14 mm nearly one year ago, 4 years prior to that is was 12 mm, same equipment, same cardio. I worry about HCM, though no family history whatsoever, long livers on both sides, average probably about 88 years, though a few have lived to 98/99.I have a connective tissue disease AS. Is it possible that my CTD could actually be responsible for the mild LVH, rather than mild HTN? I consider my HTN very controlled , it's probably been averaging around 115/75 the last few years.

I've also been diagnosed with costochondritis and FM secondary to my CTD, Could these have any link or be contributing factors for my intermittant palpitations (PVCs & tachycardia)? These are also very controlled with atenolol and losartan.

I have an history of life long epsiodes of tachycardia & PVCs and rapid heartrates.I do have anxiety issues which doesn't help. I have a very slight intermittant delta wave is lead ll on my ECG , barely noticable, normal on computer printout and cardio assessment but I've been told I don't have WPW, any opinions or thoughts? Are intermittent delta waves common without a diagnosis of WPW?

My last echo was done in July 2005, I was told by my cardio to have another in 2 years, Do you think with the info provided that this is a reasonable time or I should have one earlier? I'm a bit worried about HCM, but I've been assured by my cardio I don't have that.

Thanks for your time and Happy Mother's Day to all the mothers.

[CCF-M.D.-MJM]

Hello,

Could these have any link or be contributing factors for my intermittant palpitations (PVCs & tachycardia)?

I haven't read anythinga bout CTD contributing to LVH.  Keep in mind that of the subset of people that have LVH, a very distinct minority have HCM.  If you do not have a family history, an outflow tract gradient on echo and the distinctive murmur on physical exam, I would say you don't have HCM either.  If you are very concerned,  you could always get a second opinion.

I have a very slight intermittant delta wave is lead ll on my ECG , barely noticable, normal on computer printout and cardio assessment but I've been told I don't have WPW, any opinions or thoughts? Are intermittent delta waves common without a diagnosis of WPW?

Intermittent delta waves are not common.  I have never seen one in a person not an anti arrhythmic medication like flecainide or procainamide.  That is a tough call and cannot say much without seeing the EKG and recordings of your tachycardia.  If you have a tachycardia and an aburptly starting and stopping tachycardia in the setting of a delta wave, an EP study would answer the question.

Do you think with the info provided that this is a reasonable time or I should have one earlier?

I think two years is fine.  It doesn't sound like there is anything leaning toward a diagnosis of HCM.

I hope this helps.  Thanks for posting and happy mothers day for all the moms out there.

[line]

We have to be relatives, I have costo and fm also. I get an echo done every year and have mild LVH with dyastolic dyfuntion. What what I understand LVH is caused by undxed high b/p, but my b/p is fine ecxept for white coat. I also read aging can cause LVH. Actually my report was better this year than it was in the last 6 years.

I did post a comment to you and others with chronic pain under a palp post. I cannot believe the people just on this board that have these dd and have mild heart problems also. I do not believe Drs. can give us answers as to a correlation between heart issues and these dd because there is not enough research on these dd.

Linda

[tickertock]

Thanks for the quick reply. I should have mentioned that I have a normal PR normal QRS, and no clean cut delta wave just an intermittent very minor slur in lead ll only, which I have been assured is nothing and that I don't have WPW, it is not even picked up on the computerized printout of the ECG. I do have tachycardia that is triggered by a PVC, its been documented on ECG but only as sinus tachycardia with PVCs. Thanks again.

[tickertock]

Who knows we might be relatives :-)! I must say I noticed alot of persons with FM and Costo also have these "benign" heart issues. I dont have any leaks of the heart valves, no obstruction and heart function I was told is very good .

One cardio told me that these CTD tend to cause palpitation in some because of the intermittent inflammation. I think some doctors acknowledge it because so many complain of it though I don't think any studies have been performed long enough to study the connection and come up with a possible link, like before there was no acknowledgement of stomach and digestive problems causing palps, now there sames to be a general agreement among most docs that there is a connection.

[momto3girls]

Hi there,

Very interesting stuff!  I too have fm and costachondritis (I think I spell that wrong everytime!)  I've never in all these years considered a link between these 2 things and my pacs and tachy.  Don't you just wish there was some research going on concerning this?  I for one do.  I've been told I have fm and costachondritis not to mention a tiny bit of fluid around my heart that appears to be just the way I'm made (:  How interesting if there's a link.  FM is so awful as I hurt all over and then my chest wall, particulary the center always hurts.  Everytime I sneeze I feel like my sternum is going to come flying out of my chest!  Thanks for the interesting post though, good info to dwell on and research myself.  I hope you feel better and get the answers and help you're looking for.  Life is hard enough without feeling crappy on top of it too!  Best wishes (:

[NanaRose]

I too have FM and Tietze Syndrome. I get an Echo every 6 months for LVOT.  Normally, people who have LVOT have HCM.  I was told I do not have HCM.   My cardio doctor never picked up LVH on some old EKG's but a second opinion doctor did.  He said it was from undiagnosed hypertension (even of the labile type) or undertreated high BP.  I am on Zebeta as this works best for me.

[tickertock]

Thanks for sharing, at least I do not have any obstruction or SAM as I think its called. As understand some with severe HTN never develop LVH and in some even mild cases causes it.

[NanaRose]

Yes, I have SAM and God only knows where I got this or why I got this.   I brought up surgery for this the other day and my cardio hit the roof....My feet do swell though but he said they are cosmetic only and not caused by the heart....But, who knows. I also wheeze at night. Why?   God only knows!

[PikaPika88]

I don't think God knows it.  If he/she knew it, he/she will probably corrected it before we born!  I think I probably born in the wrong planet!

I've wpw and mildly enlarge left ventricle.  Some said the ablation will cause enlarge left ventricle.  I wasn't know it is true or not.  I think the CCF drs know it.  Non of my ECG showed wpw in the hospital's print out but it showed in the surgery/clinic's ECG print out. So not all the ECG will print out wpw syndrome.

Could the palps cause stomach and digestive problems? or just the stomach and digestive problems causing palps?  Either way?

Pika.

[jan]

I have costo and IST, NCS, mild valvular disease, and a whole host of other weird chronic things.  A neuro from CCF recommended I get tested for mitochondrial disorder.  

I happened to meet someone in a chatroom that had the same conditions I did and was getting tested for the others I had already been diagnosed with.  We were health twins.  She said she had mito disorder and thought I should be tested.  I asked her how they treated it and she said they treat the symptoms, so I didn't get tested.  They're already treating my symptoms, why hassle with yet another test???

I believe there has to be a reason I am getting all of these things.  When I was misdiag with MS my primary said finally someone put it altogether, but it seems it was a misdiag (altho it doesn't seem like all my drs. believe it was).

[woodruff]

Years ago, I was diagnosed with mild FM, and have also had off-and-on-again bouts of costochondritis.  This was never bad enough to keep me away from the gym, though, and for over 30 years, I’ve done cardio and weights four to six days a week.  Exercise is no absolute guarantee of anything, of course, and as time has gone by, I’ve developed panic disorder and labile hypertension (generally under 120/80, but in the 190/100 range for brief periods when I’m panicked--or sometimes for no reason I can determine).  Over the years, I have also had occasional bouts of what were diagnosed as benign PVCs.  However, until recently, when checked out via EKGs and stethoscope, my heart has been otherwise boringly healthy.

Three years ago, I got a case of food poisoning from brunch at a local restaurant.  Three weeks after that, I developed sacroiliac pain, and subsequently, various swollen joints (fingers and knees, mostly).  After a number of months, two rheumatologists diagnosed me with Reactive Arthritis, the politically-correct name these days for Reiter’s Syndrome.  The joint pain and inflammation have faded, but this year, for the first time, my doc heard a real heart murmur, and after stress-echo studies and so on, I was found to have mild eccentric LVH, a floppy aortic valve, and some degree of aortic regurgitation.  My new cardiologist associates it with aging and hypertension, and says it tends to be a relatively stable condition, but now I will be echoed every year to watch that left ventricle, in the hopes of catching any further hypertrophy, with an eye towards putting in a new aortic valve, if needed.

I brought up the question with my cardiologist about a link between Reactive Arthritis and valvular damage, but he wasn’t very impressed with the idea, because he says aortic regurg is more typically associated with ankylosing spondylitis.  However, we’re talking about seronegative spondyloarthropathies here, of which Reactive Arthritis is an example.  I have read two studies that indicate that this disease can indeed be associated with preferential damage to the aortic valve.  Who knows, huh?  But it looks as though a number of us here on the heart board do share some interesting traits.

[tickertock]

My brother has Reiters Syndrome/Reactive arthritis , he was diangnosed in 1992, he will be 49 this year, I have ankylosing spondylitis, I was diagnosed in 2000, I will 42 this year. This is the main reason I get checked out with an echo to keep an eye for aortic valve damage, so far so so good, no damage or leaks.It is my understanding that AS and RS/RA can cause minor aortic valve damage and minor conduction problems with the heart.