Minimally dilated left ventricle

Hello. I am a 27 year old male and recently had an echo, stress echo and MRI related due to symptoms of tachycardia and very forceful heartbeats--especially in the a.m. I found that 250 mg of magnesium reduced these symptoms and informed the dr I was using it.  My bp, thyroid and lipids are all normal.  I used to drink and smoke heavily for several yrs, and used amphetamines (prescribed) for several months, but have quit them all.

My original echo showed a "LVEF of 45-50% with mild global hypokinesia", after which I stopped taking magnesium.  For reasons I don't have space to explain here I next had an MRI with another physician.  Her findings were "minimally increased left ventricular cavity size with normal regional and global systolic function.  EF is 60%".  No other abnormalities on either report.

I showed this to my original dr and had a stress test w/her, which was negative with a "resting" ef of 60%.  I don't know however if this was truly an accurate picture of my resting heart as I was extremely nervous about the test--my heart was throbbing and going 100 bpm at rest.  

My questions are 1 How reliable are the results of my original echo, and is it possible my EF could have been low due to taking magnesium? 2  Isn't left ventricular cavity dilation a feature of ventricular remodelling?-although it was minimal (LVEDV index=81, normal under 80, LVIDd index=34, normal under 31), I'm very concerned this could be an early feature of heart failure.  3 How reliable is my "resting" stress echo image-could my EF have been falsely elevated due to my nervousness?

[CCF-M.D.-BJ]

Hi Samroad,

I cannot answer these questions accurately without seeing the studies.  Anything from reader variability to transiently depressed LV dysfunction could explain this.

Cavity dilation is usually a feature of a cardiomypathy. It all depends on the degree of dilation.  LVEDV index is not an indicator that I am familiar with.

It is true that your EF can increase if you nervous.  The degree of improvement is difficult to speculate on.

It is essential that you no longer smoke, drink heavily or especially use amphetamines as these can all significantly effect heart function.

I hope this helps.