Re: Want to know more about echocardiogram results; PAC, PAT, PVCs

Posted By leo1917 on April 15, 1999 at 12:20:59
I am a 42-year old female diagnosed with PACs, PATs, and PVCs.  My primary care physician and cardiologist has told me the condition is not serious.  I had a stess test, EKGs, wore a halter monitor and an event monitor for a month.  Last week I had an echocardiogram performed.  I have questions about the results.  My PCP and cariologist told me that I have a slightly enlarged left atrium, and a slight elevation in the pressure of the right pulmonary artery.  They both said that this does not amount to anything.  My PCP told me that because I am a highly stressed, anxious person, that the pressure increase is not a surprise and there's nothing to worry about.  My cardiologist told me that having a slightly enlarged left atrium is OK - that about 20 to 60 % of people have this who have had echocardiograms done.  The cardiologist also said that people who live at higher altitudes (I live in Denver) often have increased pressure in pulmonary arteries, ranging from 25 to 35.  My number was in the middle (I'm assuming about 30).  Both doctors said that the remainder of the results of the echo are very normal and everything looks good.  Both doctors feel that my irregular heartbeats (they are less in frequency now that I am taking Atenolol) are not related to the results of the echo.  I would like your opinion on what I have been told.
Thanks

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on April 15, 1999 at 15:17:39

Dear leo1917,
Are you or have you been a smoker by any chance?
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

[Doren__0]

Posted By Doreen on April 16, 1999 at 16:31:15
In answer to your question, yes I was a smoker but quite several years ago.  The only alergy (allergy) I have is to cats - I get very wheezy around them.  I have had a chronic cough off and on for most of my adult life.  Had a pulmonary function test done - scored very well.  Had a lung scan and lung x-ray done recently, both were fine.  I don't seem to have trouble breathing or with my heart while excercizing.  Any info you can provide my way about those echocardiogram result would be a help.
thanks

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on April 16, 1999 at 18:09:20

I tend to agree with your doctors that this is nothing to worry about.  Your PA pressure is only mildly elevated and the echo results are not worrysome.  Are you having symptoms of any sort?
CRC

[Doren__0]

Posted By Doreen on April 16, 1999 at 18:26:32
Thank you for your response.  The symptoms I've had that were bothersome were the PATs, PACs, and PVCs (which I've had on and off for 20 years or so).  They have become worse lately but all the tests have shown them to be benign.  They are just so scary sometimes!  I do get chest pain; more like short, sharp (but not serious, death-defying pain) jabs underneath left breast and other areas, they usually don't accompany the irregular hearbeats.  They rarely last more than a few seconds each.  They usually don't occur during excercise, just when I'm sitting around.  I actually caught these pains alot on the event monitor, but results were fine.  Other symptoms: just alot of fatigue during the day which seems to come from anxiety, depression, and getting less than 8 hours of sleep almost all of the time (but who knows...). I am usually physically active and can hike, jog, and walk with no serious problems.
Questions: what are some things that cause a slight elevation in pulmonary pressure?  Can I do something to reduce it?  Would having a slightly enlarged left atrium be a result of my basic physiology?
This web page was a wonderful idea.  If I had money I would make an appointment and travel to Ohio!  Too bad you don't offer scholarships.  

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on April 16, 1999 at 21:23:54
Potential causes of mild elevations of pulmonary pressure are high blood pressure, smoking, heart valve problems, other rare congenital heart problems and primary elevation of pulmonary pressure. There is nothing that can be done to lwer pulmonary pressure other than treatment of any underlying causes.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician
can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire
online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your cardiac problem.

[Doren__0]

Posted By Doreen on April 19, 1999 at 10:33:47
Thank you for your response.  My ECG showed no valve problems, and as far as I know I have no rare congenital heart problems. Heart function was basically normal.  I used to smoke but quite several years ago.  If there's nothing that can be done to lower this pressure, then is it possible to live with this mild condition into old age?
Also, do you have any comments on a 'barely' mildy enlarged left atrium?  My cardiologist says it is not a problem.  Can it be tied in with the mildy increased right pulmonary pressure?
Would a cat scan for calcium (from Colorado Heart Imaging) help diagnose this situation?
Thanks.

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on April 19, 1999 at 13:11:57

Dear Doreen,
Yes, it is possible to live to a ripe old age with mildly elevated pulmonary pressures.  And I would agree with your doctor that a mildly enlarged atrium is nothing to worry about.  As far as the CT goes do you mean an ultrafast CT scan for the diagnosis of coronary artery disease?  Did your doctor recommend this?
CRC

[Doren__0]

Posted By Doreen on April 19, 1999 at 15:46:05
Thank you for your response.  I actually responded to your last answer but I think my questions were lost.  My cardiologist ordered the ultrafast CT for me because he knows I'm very worried about having a heart attack.  He doesn't think the test will show any problems whatsoever.  
Do you have any statistics on how many so-called 'normal' people have mildly enlarged left atriums and/or mildly elevated right pulmonary artery pressure?  My doctors say it is not uncommon to see these abnormalities in people who never develop heart problems.  
Sorry for all the questions but with PVCs, PATs, PACs, short jabs of chest pain,  my anxiety is heightened.

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Re: Want to know more about echocardiogram results; PAC, PAT, PVCs CCF CARDIO MD - CRC 4/20/1999
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