echo findings

[dmmom]

Can someone please clarify what the following mean:
1. both left and right atria appeared to be upper limits of normal in size.
2. evidence of mild to moderate concentric left ventricular hypertrophy.
3. aortic valve appeared trileaflet with mild degree of fibrocalcific change and overal well preserved excursion and closure.
4. mitral valve demonstrated mild sclerosis with preserved excursion and closure. Doppler evaluation reavealed some prominence of the A-wave on inflow analysis in keeping with diminished left ventricular compliance/abnormal relaxation/mild diastolic dysfunction.
5. tricuspid valve appeared to be structurally normal.  Right sided pressures were not estimated.
6. pulmonic valve was never well visualized.
I know this  is a lot but my doctor has moved out of state and I haven't heard back from another doctor yet.  Is any of this something that I should be concerned about?  
Thanks.

[CCF-M.D.-MJM]

Hi dmmom,

You should not worry about this echo, although it does sugggest you may have high blood pressure.  Are you treated for high blood pressure?  It is also important to know why the echo was ordered, how old you are, do you have any medical problems or other symptoms?

1. both left and right atria appeared to be upper limits of normal in size.

Your atria are normal sized, but are on the upper end of normal.  High blood pressure can cause this.

2. evidence of mild to moderate concentric left ventricular hypertrophy.

Your ventricular walls are thicker than normal.  This suggests you may have high blood pressure.  It can also come from other genetic causes, but that is where history and the experience of the echo tech and reader become important.

3. aortic valve appeared trileaflet with mild degree of fibrocalcific change and overal well preserved excursion and closure.
You aortic valve is normal structure and opens normal.  As we age, some people develop some extra tissue around the aortic valve (fibrosis), but in the absence of increased pressure gradients across the valve, this is not a concern.

4. mitral valve demonstrated mild sclerosis with preserved excursion and closure. Doppler evaluation reavealed some prominence of the A-wave on inflow analysis in keeping with diminished left ventricular compliance/abnormal relaxation/mild diastolic dysfunction.

Same answer as above for the valve.  The A wave issue is used to evaluate diastolic function.  It is consistent to with what  you would expect for someone with LVH or hypertrophy.  The key is to control the blood pressure if it is high or boarderline.

5. tricuspid valve appeared to be structurally normal. Right sided pressures were not estimated.
6. pulmonic valve was never well visualized.

5. and 6. are normal.

I hope this helps and good luck in finding a new cardiologist.

Thank you for asking about my eye.  I am not longer wearing a patch and my vision is near normal again.  As a comic aside, my daughter poked me in the other eye yesterday morning.  This time without a corneal abration.

[uptowngirl]

Good questions, I'm looking forward to the Dr. response.  A couple of those findings were similar to one of my reports.

MJM--Is your scratched cornea better???  Thanks for answering the recent questions in spite of your injury.

Uptown girl

[knicks30]

so basically everyone with a degree of left ventricular hypertrophy there is evidence of diastolic dysfunction?

can someone clarify that for me please? thanks.

[CCF-M.D.-MJM]

Not always, but usually.  Just because you have echocardiographic evidence of diastolic dysfunction does not mean you will have symptoms.  It should be taken seriously because it is possible to prevent further progression with tight blood pressure control.

[dmmom]

First, thanks so much for answering my questions. To answer your questions - I am a 47 year old female.  I am taking blood pressure meds (Hyzaar 100-25) and cholesterol med (lipitor 20 mg). I have been on these meds for about five years. Five years ago I was diagnosed thru an echo with bicuspid aortic valve, but now I wonder if this is correct. This echo was just a check to see if the bicuspid valve was still the same. You replied that many of the findings in the echo pointed to high blood pressure - does that mean that even though I am taking Hyzaar it might not be under control?  I keep tabs on it at home and it is usually really good, but I am one of those people that as soon as I go to the dr. it shoots up!  Thanks again for clarifying some of my questions.  Also, is it okay to have family doctor take care of blood pressure until I can find another Cardiologist?

[mbimom]

I read your comment to your post and noticed that you said this echo was done to see if your bicuspid aortic valve had progressed and if you read your echo report it says you have a trileaflet artic valve. This contradicts your bicuspid valve diagnosis. Have you been told that you need antibiotics before dentist appt or surgery? My daughter and I both have bicupid aortic valve with insufficiency and our cardiologist says it is extremely important for both of us to take the antiobitics. You need to get a correct diagnosis. Both my daughter and I were told by another cardiologist that we did not have bicuspid aortic valves that we just had a lot of clicks when they listened to our hearts. There is an echo called a TEE where they go down you throat and take pictures it gives a better image you may need this to see what is going on. One other thing my daughters valve is called a tricommiserate bicuspid aortic valve which means she has 3 leaflets but they are fused together making it essentially 2. I think maybe this could be what you have causing the different diagnosis. Just some thoughts.

[dmmom]

Hi, thanks for your comments.  Yes, I do take antibiotics before dental appts.  I would imagine that I would still take antibiotics when I find a new cardiologist because of the two different diagnosis.  I'm just soooo not looking forward to trying to find a new cardiologist.  I guess for now I will go to our family doctor for the high blood pressure (even though the cardiologist is who prescribed my meds).  Maybe he can recommend a new cardiologist, although I still have to look into insurance, etc. to see who they cover.
Thanks again.