"normal" echo...but not!

[roxstua]

I went to the cardiologist with chest pain with radiating down my left arm, jaw pain, nausea and extreme fatigue.  They did an echo and I was told over the phone that everything was fine.  Then, I got the report. I have a degree in microbiology and taught anatomy and physiology for 26 yrs. so I am quite able to read and interpret a medical report. I do not, however, have years of medical experience like a dr.  The report showed concentric ventricular hypertrophy with grade 1 diastolic dysfunction. The tricuspid valve had regurgitation and there was mild pulmonary hypertension. The conclusions of the report were that there were no changes from the echo a year before...but I have that report and there is no mention of any of the above....How is it possible for this to be no change from before and normal? I am still having the symptoms and am going to another cardiologist next week as I have lost some confidence in my present doc. I also have rheumatoid arthritis. Could these results explain my symptoms?

[ayl291]

Technically they could, as a microbiologist you understand that any inflammatory condition can mean othwr organs, tissues are affected.

It seems like hyopertrophy vs dilation.

And the in increased Pulmonary pressure could be due to pvh instead of pah.  I suggest you go to a good team asap.  Where are you currently located... you can pm instead.

[Flycaster305]

You have come to some excellent conclusions in my opinion and have been offered good advice.  The words 'mild' and 'moderate' are music to my ears when I see them in a report as my Ejection Fraction is not so good.  However, careful attention to diet and exercise plus really good medications have arrested my issues.  Kenkeith is correct, once the right ventrical enlarges heart failure is right around the corner.

Given you family hx I'd agree that you need to change or continue good cardiac health decisions.  

[roxstua]

Thanks kenkeith...my grandmother died from heart failure and my dad has it now.  That is a concern of mine and I plan on discussing it with my new dr this week.
  

[kenkeith]

Because you have a family history of heart disease, your doctor and you should have some interest in a higher than normal pulmonary pressure.  This also can be genetically passed and uncorrected or properly treated that can lead to right side heart failure. The normal pulmonary artery systolic pressure is 15–30 Hg.

For some insight, there are several basic problems in pulmonary hypertension patients. Sometimes the small blood vessels in your lungs constrict (get narrow, tighten up) and this makes it very hard for your heart to push blood through them.

Another problem is blood clots. People with PH may get chronic blood clots, which can further block small blood vessels in the lungs. All these things add up to an overworked heart and a real hard time breathing.

Right ventrical will enlarge to compensate that starts a pathological condition of heart failure.  Just something to keep in mind.

[roxstua]

Thanks erijon...after reading several other posts on these topics, I have decided that I have nothing to worry about after all.  I guess I am just a bit jumpy because of my truly awful family history.  My dad is alive because he watches out for all of this stuff.  All of the other men in his family died before the age of 45 because of heart attacks.  His sisters have all had events also.  My dad happened to be the baby of the family and started having his problems right when they invented bypass surgery.  He had a 5 way. So you see I have been trained to be wary.

[erijon]

Your report sounds normal for the most part. Your EF is great and a Grade 1 Diastolic dysfunction is a fairly common finding and is not a serious issue, it may very well not be the case on your next echo. I had it on one 4 years ago and the cardiologist said not to worry about it and as she said it would be, it was gone on the echo done the following year.

As far as borderline HCM, that would explain the finding of the DD as it may inhibit your left ventricle from relaxing enough to fill properly, but again it is only a grade 1 which is the lowest possible. Also, trace regurgitation is not an issue and a normal finding.

You have high cholesterol, mostly due to high LDL (bad) cholesterol and high TGL's. You want to work your LDL under 130 and TGL's under 150.  

I think the key thing here is to repeat the echo in a year and see if the HCM has progressed and if the pulmonary hypertension has gotten worse.

Hope this helps,

Jon

[roxstua]

Well, I tried to answer your questions but apparently they did not post. I will try again. The echo report: EF=55=69%(good). The diastolic filling pattern indicates Grade1 diastolic dysfunction.  There is borderline concentric ventricular hypertrophy.  Trace tricuspid regurgitation present.  There is mild pulmonary hypertension. rt. ventricular systolic pressure is 43mmHg. Apparently, I have an undiagnosed murmur. Total cholesterol is 240. Triglycerides are 207. HDL is 47. LDL is 152. My nuclear stress test is normal. That is all I know besides what I wrote before. Thank-you for your help!

[ChatterAlly]

Did they do any blood tests or other test?  

[erijon]

Can you share the report summary with us? It would help answer your question.

Jon

[Piyush123]

please  tell me what is normal left ventricular function ?and treetment