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Results of Echo? LAE? PLEASE HELP.
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Results of Echo? LAE? PLEASE HELP.

Responses from doctors, esp. from cardiologists, to interpret my echocardiogram (echo) would be VERY much appreciated.  I'm a little scared about the results.  I welcome multiple responses.  And thank you VERY much in advance for your help. I've never posted anything anywhere online in my life.  I was very pleased to discover this resource.

MY GENERAL BACKGROUND: I'm male, married, 35 years-old, 5' 11" and about 195 lbs.  I have gained about 20-30 lbs over the last 10 years since graduate school, and my blood pressure has creeped up a bit too (normal range when I'm relaxed in the morning or evening, but can be 140/80 or higher if I'm upset, which in my profession is common during the day).  

I used to be more athletic (before kids, about 5 years ago) - for example, occasionally I would run a 10K or half-marathon, sometimes I would run 3-5 miles a couple times per week and then not doing any running for a couple months and then start up again - never any consistent regular workout program though.  For the last 5 years or so, I’ve been much more sedentary - I can jog 3-6 miles, but it hurts and I don’t do much aerobic exercise these days.  

I am a long-time sufferer of anxiety and panic disorder (dating back 15 years or so).  Over the last 15 years, I have had quite a few tests -- all of them have come back fairly normal.    

ECHO  HISTORY: About 2 years ago, I complained to my internist about generalized shortness of breath (and also some shortness of breath when I tried to startup running again), which I still suffer from.  My internist ordered my echo.  

Several days ago, I followed-up with my internist about anxiety and heart palpitations (and the shortness of breath).  She listened to my chest, said she heard the "skipped beats," gave me a copy of my echo results (from 2 years ago) and told me that my heart was normal.  She said I was suffering from anxiety, nothing more, and that my heart was very "normal."  

I felt fairly relieved, and left.  Tonight (PST), I read the echo results - I was surprised to see no stamp of "normal" or "no significant test abnormalities," which I have seen stamped on other test results from my internist - I was also surprised to see that the results included "mild LAE" and "mild TR."  

After doing some research, I'm less concerned about the "mild TR," as from what I understand a great deal of the "normal" adult population has some "mild TR;" but I am somewhat upset about the "mild LAE," because I can't seem to locate online information to confirm, for me, that it is in fact "mild."  

My full echo report is at the end of this posting.  I also included the details of a Holter Monitor Report from the same time period as my echo (about 2 years ago).

1. QUESTION ONE: What is normal LA size in terms of "___ x ___ cm")?  

2. QUESTION TWO: Is my LA enlargement ("4.1 x 5.3 cm") just barely above "normal," "mild" or more serious?  

3. QUESTION THREE: Is my LA enlargement ("4.1 x 5.3 cm") just barely above "normal," "mild" or more serious if based on the following parameters taken from an article in the Journal of the American College of Cardiology: "[normal LA size] using the 'leading edge to leading edge' method, in centimeters, measured from M-mode in the parasternal long-axis view at the end of ventricular systole. ... [is] often classified as follows: (1) Normal size: equal to or less than 4.0 cm; (2) Mild enlargement: 4.1 to 4.5 cm; (3) Moderate enlargement: 4.6 to 5.5 cm; and (4) Severe enlargement: greater than 5.5 cm"  The article did not provide ranges in terms of "___ x ___ cm" for LA size while my echo did, making the comparison between the article and my echo difficult on my end.  

4. QUESTION FOUR: Is there anything I can do to reduce the size of my LA? Reduce my blood pressure?  Lose weight?  Anything?

ECHO REPORT (2 years ago):  "Cardiac Chambers: The RA and RV appear normal.  The LA is mildly enlarged measuring 4.1 x 5.3 cm.  LV wall thickness is normal with normal LV cavity size measuring 5.1 cm at end-diastole. LV systolic function is normal with an estimated LVEF of 64%.  No regional wall motion abnormalities were identified.  Diastology appears normal.  Cardiac valves: All four cardiac valves appeared normal and there is mild TR.  The peak TR pressure gradient is 24 mmHg with an estimated RVSP of 30 mmHg.  Extracardiac structures: The aortic root, PA and IVC diameters appeared normal.  There is no pericardial effusion.  Rhythm: Normal sinus rhythm with a heart rate of 85 bpm [which is high for me; I was nervous about the testing].  Conclusions: Normal LV systolic function.  Mild LAE.  Mild TR.  No evidence of significant pulmonary hypertension."

HOLTER MONITOR REPORT (2 years ago): "Cardiovascular symptoms reported were muscular pain, left chest discomfort, shortness of breath, and dizziness.  Symptoms did not correlate with any arrhythmia.  No brady arrhythmia seen.  PAC rare [choices were circle [rare, occasional or frequent.]  No clinically significant tachycardia seen.  NO SIGNIFICANT TEST ABNORMALITIES."

BLOOD TESTS (2 years ago): CBC all normal range.
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61536_tn?1340701763
Glad you found us, it's a great place here.

The blood pressure may be weight-related, it's important to work on keeping the numbers low - 120/80 or less.  Your body undoubtedly misses the workouts, it lowers your BP with consistency.

Are you doing anything to manage the anxiety?  Exercise can help ease those symptoms too.  Speaking from experience ;)  Anxiety can cause shortness of breath.  

I felt fairly relieved, and left.  Tonight (PST), I read the echo results - I was surprised to see no stamp of "normal" or "no significant test abnormalities," which I have seen stamped on other test results from my internist - I was also surprised to see that the results included "mild LAE" and "mild TR."    

1. QUESTION ONE: What is normal LA size in terms of "___ x ___ cm")?  

This would depend entirely on you as an individual,  There is no way of saying with certainty what is or would be normal.  "Normal" on an echo is rare.  Almost everyone has something, trace regurgitation, a slightly enlarged something, but these can still fall "within normal limits", and it sounds like yours does.

2. QUESTION TWO: Is my LA enlargement ("4.1 x 5.3 cm") just barely above "normal," "mild" or more serious?  

I would suspect that it is very close to normal, or within normal limits, if follow-up was not ordered and no concerns were raised by your physician.

3. QUESTION THREE: Is my LA enlargement ("4.1 x 5.3 cm") just barely above "normal," "mild" or more serious if based on the following parameters taken from an article in the Journal of the American College of Cardiology: "[normal LA size] using the 'leading edge to leading edge' method, in centimeters, measured from M-mode in the parasternal long-axis view at the end of ventricular systole. ... [is] often classified as follows: (1) Normal size: equal to or less than 4.0 cm; (2) Mild enlargement: 4.1 to 4.5 cm; (3) Moderate enlargement: 4.6 to 5.5 cm; and (4) Severe enlargement: greater than 5.5 cm"  The article did not provide ranges in terms of "___ x ___ cm" for LA size while my echo did, making the comparison between the article and my echo difficult on my end.  

I wouldn't use internet quotes on size, it could be very misleading.

4. QUESTION FOUR: Is there anything I can do to reduce the size of my LA? Reduce my blood pressure?  Lose weight?  Anything?

It depends on what is causing it.  You said you used to be athletic, I would assume it is possible this could have been a factor.  Blood pressure can also cause some enlargement, though I'm not sure specifically of LAE.  Blood pressure reduction sure can't hurt.

You sound normal.
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