Stress echo result interpretation? Is this normal???

[mica612]

I just got the results of my stress test.

LVM = 177gm or 103 gm/m
LVEF = 55%
LV diastolic cavity diameter = 5.3cm
LV systolic cavity diameter  = 3.5cm
Septal wall thickness = 0.8cm
LV septum / posterior wall ratio = 1

Mitral E/A ratio = 2.58
Mitral E Decel Time = 217ms

Left atrium: LA AP diamater = 3.4 cm or 1.94cm/m2
Aortic valve: LVOT doppler VTI (cm) = 21

Right heart pressure:
PA systolic = 20mmHg
RA pressure = 4mmHg TR
TR Doppler gradient = 17mmHg

Does that mean I have an enlarged heart (HCM or athlete's heart)? Also, my LVEF went from 55% at rest to 75% after stress test. Is that good or bad?? Apparently, my E/A ratio is high - what does that mean?

[kenkeith]

American Heart Academy:  EF higher than 75 percent could indicate a heart condition like hypertrophic cardiomyopathy.

The normal heart will dilate to increase cardiac output to meet the systems's demand for oxygenated blood and stay within the range of 55 to 75% ejection fraction.  The dilation (like stretching a rubber band) increases cardiac output, but to overstretch (not unlike stretching a handspring, an over stretch spring becomes flaccid) the EF can quickly drop from a high EF to a failing heart disorder. The heart has overcompensated.

Also, stronger contractions can be represented by thicker heart walls that are not pathogenic (athlete's heart) or the the thick walls can be due to a diseased condition such as high blood pressure causing the heart to overwork. Thickened heart walls can cause diastolic dysfunciton (filling phase).

E/A ratio is a calculation to evaluate the filling phase of heartbeat cycle.  "E" represents the beginning of the filling phase and at that time the velocity and volume is the highest and "A" is the time at the end of the filling phase the volume and velocity decreases.  There is a normal pattern and calculation for A/E normal diastole functionality.

With more severe diastolic dysfunction, LV compliance reduces and LA pressures rise. The low compliance of the LV causes a rapid increase in the early LV pressure and a shortened inflow and the E/A ratio is > 2.

With all that said the left atrium should be enlarged and it isn't?!  The 75% EF is an estimate and the margin of error is about 5% so that is not excessively high. The high E/A ratio can be due to a diastole dysfunction.  Just based on the information provided cannot be considered for an evaluation.  I have provided general information and anything specific analysis would require a doctor's knowledge of health history, other tests, symptoms, etc.
Hope this helps.