Severety of heart disease

[Ger57]

My cardiologist says everything is stable and no need to worry. No restriction in sporting.
I however have my doubts about the severity of my heart disease.
Can anyone shed some extra light on my condition?

In 2013 I was diagnosed LAD stenosis and moderate Mitral regurgitation. I had a stent placed in LAD for severe blockage (>90%). 1 week after stenting, I got an infarction (STEMI) due to in-stent stenosis which I survived with light heart muscle damage.
In 2014 additional 4 stents were placed for stenosis in LAD (2x) and in RCA (2x) and echo doppler now also revealed severely enlarged right atrium (RA) with both Mitral (moderate) and Tricuspid (light) regurgitation while the leaflets on both valves are thickened. Other 2 valves are ok.
I feel not too bad and can still exercise quite good.

[ed34]

I'm surprised an exercise stress test is necessary with a RA enlargement. It can only become enlarged if a pulmonary issue is evident. Of course, your tricuspid valve could be severely malfunctioning but the report says this is 'light'.

[Ger57]

He has planned an in hospital cycling stress test for me in 4 weeks and a consultation afterwards. Hope that is safe.
I find it increasingly strange that he did not mention the RA aspect, but also that the person performing the echo and writing the report did not find it prudent to mention in the summary of the report.

[ed34]

Just to add, until I had an explanation I would stop doing the exercises just to be on the safe side. If you have high pressure or a pulmonary blockage of some kind then I wouldn't want to make matters any worse.

[ed34]

absolutely I do. If it said mild enlargement then I wouldn't be so concerned, but severely? surely this warrants a good explanation.

[Ger57]

Thanks ed34. I asked my cardiologist for a copy of the echo doppler report. The summary did only mention the state of the valves and further that ejection fraction was ok and ventricles and LA not enlarged. Only in the details I found that RA severely enlarged and VCI=42%.  As I got to read the report after seeing him, I could not ask his comments on RA. Do you think it needs to be discussed (soon)?

[ed34]

I would seek a second opinion. With a severely enlarged right atrium, it can be a sign of pressure issues in your pulmonary system. This is the side of the heart that pumps blood through your Lungs to become oxygenated.