What does a diagnosis of Moderate tricuspid regurgitation with pulmonary artery pressure of 40 mean and also, what does hyperdynamic left ventricle mean?

[spicnspan]

I'm a small female, 107 lbs,  52 yrs old, with possible mild asthma - severe allergies - and Raynaud's with no Rheumatoid Diseases.  Healthy otherwise.  I'm very concerned - please let me know if this is serious or not?  

I recently had an echo with conclusions:

1.  Left ventricular synergy (IS THIS GOOD OR BAD?)
2.  Hyperdynamic left ventricle (EF = 75%)  (IS THIS OK?)
3.  Mild mitral regurgitation
4.  Moderate tricuspid regurgitation (estimated pulmonary artery pressure = 40 mmHg)  (A RECENT CHEST X-RAY SHOWED HYPERINFLATED LUNGS DUE MOST LIKELY TO ASTHMA - COULD I HAVE PULMONARY HYPERTENSION? Should I be concerned?)  - A pulmonary function test 6 mo. ago was normal

Ejection Fraction is 75-77%
Fractional shortening is 45%

On the "Apical 4 chamber view", the Right ventricle and Right atrium appear somewhat enlarged.  But on the m-mode echo, the right ventricle and left ventricle are normal.  All four cavities are demonstrated.  The tricuspid, aortic and mitral valves have normal spatial relation.

"Parasternal short-axis view":  Wide open right ventricular outflow tract and main pulmonary artery.
Tricuspid and pulmonic valves move freely.

"Parasternal long-axis view":  Right ventricle, aortic root and left atrium have normal spatial relation.  

Doppler Measurements: Peak Volocity:    Pulmonic Valve - .96
                                                             Aortic Valve - 1.10
                                                             Tricuspid Valve - .73
                                                             Mitral Valve - .99

Doppler flow analysis:  Interrogation of the mitral, tricuspid, aortic and pulmonic valves was accomplished.  There is systolic flow across the mitral valve into the low left atrium; systolic flow across the tricuspid valve in the low right atrium.

ON A SCALE OF 1-10, HOW SERIOUS IS IT?

Thank you for any help you can give me!

[kenkeith]

1. Left ventricular synergy indicates cooperative action with myocardium (heart tissue) for wall movement (contractions) interaction with the mitral valve apparatus.

2. The EF is slightly high, but that is an estimate.  Normal is 50-70% and a high EF can indicate some enlargement of the left ventricle...increases contractional strength, usually to compensate.  If it gets too high, that can stress the heart muscle and quickly reduce contractions to heart failure (EF below 29%)

3. Mild MVR is not considered significant and no problem.

4. Tricuspid regurgitation may not produce any symptoms if the patient does not have pulmonary hypertension. If pulmonary hypertension and moderate-to-severe tricuspid regurgitation exist together, the following symptoms may result:

Active pulsing in the neck veins
Swelling of the abdomen
Swelling of the feet and ankles
Fatigue, tiredness
Weakness

PH can be primary, but in view of your pulmonary issues it is likely to be secondary, and successful treatment of the underlying cause should normalize PH.  Normal PH at rest is 25 mm hg and with exercise 30 mm hg.

EF (ejection fraction...amount of blood pumped with each stroke) differs from FS in that the EF calculation deals with volume (end systole volume subtracted from end diastole volume divided by end diastole vloume.  Normal is 50 to 70%.  The calculation shows that an increase in end diastole (dilated LV) increases EF and that accounts for the slightly higher than normal EF.

FS (fractional shortening) calculation deals with left ventricle dimensions. The calculation is the difference between end diastole dimension and end systole dimension divided by end diastole dimension.  Normal range is 18 to 42%.  Your 45% FS is slightly higher than normal due some LV dilation...The calculations are estimates and if the margin of error is considered the result would be normal.  The M-modes for dimensions are not listed so I am unable to confirm.

No problems noted with the rest of the report.

The issue with the respiratory system is the only noteworthy condition that requires treatment and attention.  PH can be serious and that would cause an enlarged right atrium and possiblly the right ventricle as well.  I am assuming PH is secondary.