Hi, i dont know the answer in fact i have a question pls help me because my anxiety is way too high right now, upon the release of my echocardiogram i was diagnosed with dilated left atrium, the impression is normal left ventricular dimensions with segmental wall motion abnormality calculated ejection fraction of 51% i undergo a bruce protocol test or stress test and landed on level 4 at 13.1 mets the cardiologist told me that i passed the stress test my question is, is there any possibility that the cardiologist have an error on the impression on my echocardiogram? The size of my left atrium is 3.70 and the normal is 3.0 to 3.5cm pls help me
Left ventricular EF is 51%,
>>>Normal EF is 50 to 70% The metric indicates tha amount of blood/oxygen is pumped out of the left ventrical with each heartbeat.
Diffuse left ventricular hypokinesis?
>>>Hypokinesis indicates there is some heart wall movement impairment (mild) if severe there would be a greater reduction of the EF.
"mildly dilated right atrium, mildly reduced RV systolic function, mild mitral valve regurgitation, mild thickening/ calcification of the anterior & posterior mitral leaflet(s), mildly enlarged right ventricle, likely secondum ASD with Lt-Rt shunt at atrial level, recommend TEE for further evaluation."
>>>There is defect (congenital) of the septum that is a wall separates the left and right atria. The defect is a hole that and where blood is passed through the hole from the left atrium to the right. Usually, insignificant, but if moderate to severe there is treament. A TEE is ultrasound from a cath donw esophogus.
Mitral valve regurgitation indicates some blood leaks back mildly into the upper atriym with each heart stroke. Cause is mild thickening with calcification of the mitral valve that pprevents the leaflets from tightly closing.
The right ventricle is slightly enlarged and that may the underlying cause for mild systolic function. As a consequence there is marginally reduced pumping of the right ventricle that pumps blood to the lungs.
Did I miss anything?
11 days ago I suffered some intense chest pain, no arm pain, no facial or jaw pain - this lasted about 20 minutes. I thought I was going to lay here and die. I called my GP on that Monday and was able to be seen in the office on last Tuesday. They performed an EKG and a CXR, then scheduled an Echo and a Stress Test for yesterday (3-17). I was notified this afternoon by my MD that I would now need to contact my cardiologists and make an appointment to have a TEE (transesophageal echocardiogram) done.
My question is about the results of the Echo. . . .can you or someone tell me what to expect from this? Am I going to have to have heart surgery, non-invasive, or invasive procedures, etc? Here is what the report concluded: Left ventricular EF is 51%, Diffuse left ventricular hypokinesis, mildly dilated right atrium, mildly reduced RV systolic function, mild mitral valve regurgitation, mild thickening/ calcification of the anterior & posterior mitral leaflet(s), mildly enlarged right ventricle, likely secondum ASD with Lt-Rt shunt at atrial level, recommend TEE for further evaluation.
I should mention that I am a post gastric bypass survivor of 13 months - with 137 lbs weight loss. I have maintained my goal weight of 125lb since Dec 27th, 2009. Do you think that this cardiac change is because of my weight loss? Should I have anything to worry about?
Thank you,
Marie
QUOTE: "If your EF% is good then your enlarged LA is most likely not an issue, depending on how large it is, did you get a measurement?"
Not to say anything you state is untrue, but attention should be and may have been done regarding an enlarged left atrium due to chamber pressures and marginally a diastole failure.
What happens with diastole failure and preserved systole (normal EF) the left ventricle chamber is reduced because the walls of the chamber has pathologically increased and stiffened. The EF can be preserved because the reduced capacity is pumped with same percentage with each stroke, but less blood gets into circulation.
For some insight, over the last decade, it has become clear that many patients with heart failure do not have a reduced EF. Instead, their EF is in the normal range (> 0.50). Such patients with heart failure and a normal EF have been termed as having diastolic heart failure. In contrast, heart failure and a reduced EF has been termed systolic heart failure. Patients with diastolic heart failure are more commonly women, elderly, and affected with hypertension. The incidence of diastolic heart failure is increasing, and such patients may now make up the majority of patients admitted with heart failure.
If your EF% is good then your enlarged LA is most likely not an issue, depending on how large it is, did you get a measurement? Most Cardiologists don't get too concerned about the finding of an enlarged LA on an echo or nuclear stress test. The only way to get an accurate measurement is with a LA volume test which is rarely done as there is usually little prognostic significance. If you have lost weight then the axis of your heart may have shifted. The way the forum doctor explained it to me was that it is like cutting a banana at a 45% angle, it will give a larger profile of the "slice" than if it were cut at a perfect 90% angle. The main concern is that blood may pool in the LA which could increase your risk of stroke.
Hope this helps,
Jon
Causes of left atrium enlargement: Mitral valve stenosis (narrowed opening) increases the pressure within the upper chamber. You don't have that problem, and mild regurgitation (back flow of blood into the upper atrium rather than pumped into circulation) shouldn't be a cause, but too much blood volume in the heart can be a cause...the underlying cause is increased heart stiffness and the pumping chamber loses its contractility and more blood comes from the lungs than is pumped out and that puts intra- chamber pressures causing an enlargement of the atrium..
Atrial fibrillation (irregular heart rate of the upper chamber) has been shown to increase the atrial size. That may be what the doctor is attempting to rule out with an event monitor.
It the cardiac (heart) output is reduced by stiffness of the left ventricle chamber, that could cause your symptoms and increase the left atrium.