TURBULENT FLOW LEFT VENTRICULAR OUTFLOW TRACT

[XFACTOR2009]

My  echo  report  from last year  suggests I have turbulent flow  at the  LVOT
There  do not appear to have  been any  measurements of it
It was  said I have  LVH   1.3  mm    parts  of the septum wall appear to be over  20mm  however
I have  had  a heart murmer   since  childhood
Initially when  doinbg this  echo they concluded  it was LVH  through hypertension,  then they decvided
that on 24  hr  monitoring, I haven't  got hypertension
aside of the  turbulent  flow and the  LVH  everything else  seemed  normal on the report,  normal  ranges
I  believe I have had HCM  since  childhood,   I  found  an ECG  with  marked  LVH  in  my med  records from when I was  in my  20s ,

Am I  right that  turbulent flow,  lifelong murmer and LVH  fit the picture of  HCM  

Also, given my  echo  found  LVH  and turbulent  flow,  ought there not be a 2nd  echo  after a  year ?>

My  echo  is  here  http://www.youtube.com/watch?v=gPFViQRBIZo&list=UUXyHtC07zrHF2eQGKET3lqg&index=1&feature=plcp

Thank you in advance

[XFACTOR2009]

http://www.flickr.com/photos/54708050@N03/7202285846/in/photostream/

Is  the link  to the image

[XFACTOR2009]

Here is an image  from my  echo  which  shows  where the measurements  were  taken and  the  quality of the image

I'd be pleased  for any overall impression of this image

The  echo  report  said the septum was  1.3   and on here it is  recorded  as  0.9    The posterior  wall recorded as  1.3

Unfortunately,  I have not been able to get the  doctors  to answer  my questions

[CCFHeartMD 15]

Hello, is hard to give you a precise answer on internet as there are several pieces of information that are missing. In general you don't diagnose a patient hypertrophic cardiomyopathy (HCM) with a septal thickness of 13 mm, and the left ventricular hypertrophy (LVH) criteria in your electrocardiogram (ECG or EKG) can be normal depending on your age. Regular physical activity can produce 2 types of left ventricular remodeling: concentric that is the thickening of the walls without enlargement of the chamber, is less physiologic and associated to more anaerobic exercise (e.g. weightlifting); the second type is the eccentric remodeling that is the physiologic enlargement of the chamber without significant thickening of the walls, and is associated to aerobic exercise. If the thickening of the interventricular septum (IVS) progress over time, the only way to remove the exercise from the equation would be to stop training but that is something you should discuss with your physician.  About the turbulent flow in the LVOT is hard to give you an answer as the images you posted on the web are not good enough to make a diagnosis. Is difficult this explain this turbulence by an IVS of 13 mm and you are assuming that your murmur is caused by the presence of hypertrophy and gradient in the LVOT.  There are other causes of LVOT’s flow acceleration that should be considered like a subaortic membrane. Finally, about the 20 mm septum you were estimating by looking at your exam, you need a lot of training to read echocardiograms as sometimes usually is hard to differentiate the myocardium (muscle) from the endocardium and you can increase the thickness erroneously.
Good luck.

[XFACTOR2009]

when  I say  the septum appears to be  20mm in parts,  that is my observation NOT  the  echo  finding