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enlarged heart

i am 30 yr old, otherwise healthy, but having BP >150/100 for last 8 years. Did abused alot of alcohal and been smoking. ABout 2yrs ago i went to doctor because of my high blood pressure. My doctor had ecg done on me, and it was foud that my heart was slightly enlarged. He gave me atenolol, that didnt make alot of difference, so i stopped taking it, eventually didnt go to doctor for another 2 years and carried on with the same lifestyle. This week when i went to a different doc for BP problem again. ECG was done again it, this showed heart enlargment again. I will go back next week for my echo, x-ray and blood tests. I do workout, but always feel stressed. Also feel palpations while climbing stairs, or after getting up from bed. I have already started BP meds, stopped drinking and smoking, taking precautions in food. However i am very worried now, as i am thinking that  i am gonna have a very short life, as i am having enlarged heart at such a young age. I live alone, and dont wanna do anything, thinking that everything is over now, dont wanna go out, feeling very depressed, i do have a depression problem though. Can u plz let me knw how dangerous is enlarged heart, and can i expect a normal life expectancy if i keep a healthy lifestyle whithout drinking and smoking, also with regular excercise. BP medicine seems to be working. Your reply will be greatly appreciated
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Avatar universal
she said evrything here is because of high blood pressure, according to her if this stays in control then everything is normal.she didnt talk about hypokinesis, but she was nt at all concerned about it. rest i think i should trust her as she is one of the best cardiologist in  this area. also she said your ef is vey fine, so should not worry
Helpful - 0
367994 tn?1304953593
What is your doctor's diagnoses of the hypokinesis? Not to talk about it is unacceptable.  Usually, the condition is the result of diminished blood flow to the area.  But it  can be due to many things such as weakness of the heart muscle, abnormal  electrical conduction in the  heart, certain valve problems... there are many causes. However, it does indicate a problem with the heart.

You may want to see another doctor because unexplained hypokinesis could mean you are not getting necessary treatment notwithstanding a healthy lifestyle.
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Avatar universal
I think i am nt worried about the thickness as it is almost close to normal. I have stopprd drinking and changed my lifestyle alot, with only healthy eating. My blood pressure stays below 120/80 (thanks to the medicine). Only think i am worried about is the hypokinesis. I hope it does not bother me in future. I think i love my life more than i should. My doctor didnt talk to me about it. so i dont know what effect it will have on my heart in future. I hope i had this lifestylr long time back, nothing would have happened then. And also my friends, try drinking a glass of bottle gaurd juice every morning at empty stomach, trust me it realy helps. And also plz let me know what effect this hypokinesis will have in future on my heart if i carry on with this healthy lifestyle.

Thanks alot
Helpful - 0
367994 tn?1304953593
If one googles reverse remodeling, there seems to be some evidence that the left ventricle can remodel if the underlying cause is high blood pressure. I have generally had the idea that dilated LV size can be reduced based on my experience, and hypertrophy LV cannot have reverse remodeling. Many heart walls thickening are due to a congenital defect and that can't be reversed and is a diastolic dysfunction.  

"Hypertrophy and dilation are results of cardiac remodeling. Under some conditions (e.g., exercise training) remodeling is beneficial; however, under other conditions (e.g., heart failure) this remodeling is deleterious because it increases the oxygen demand of the heart and decreases mechanical efficiency. Certain drugs, such as beta-blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have been shown to prevent or partially reverse remodeling under pathologic conditions".

Some antihypertensive drugs may cause LVH to regress but this is controversial. Athletic hypertrophy does not require treatment. So there is no clear answer that I have found.
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159619 tn?1707018272
COMMUNITY LEADER
It was always my understanding that thickened walls will not remodel back to a normal size, is that your understanding as well?
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367994 tn?1304953593
If you have a serious drinking problem, you certaining want to cut back.  Excessive alcohol can cause an enlarged heart, but there are indications that some long-term alcoholics may suffer from cardiomyopathy (heart muscle damage) and cause hypokinesis, and that reduces the heart's ability to pump effectively..

High blood pressure can also enlarge the heart as high blood pressure is an indication the heart is overworked by pumping against higher than normal vessel resistance and the there can be dilated cardiomyopathy. I had that condition and medication that dilated the vessels reduced the heart's workload, and there was reverse remodeling of heart size to now normal size.
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159619 tn?1707018272
COMMUNITY LEADER
For what it's worth, 1.2cm is considered normal by some labs, 1.1cm by others. Mine is 1.2cm (52 years old) and is considered normal. She was probably worried because of you age. Don't drink too much and keep your BP under control and it should stay stable. That's very important because it will not usually go back down so be responsible and stay healthy.

Jon
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Avatar universal
Thanks alot for you help. So everything seems to be fine, my doctor didnt talk with me about hypokinesis, all she was worried about wall thikness, and she said it was because of high alcohal and blood pressure, i am controlling both of it and feel fine. So i think if i stay in control, everything will be fine. Thus there is nothing to worry about and the damage is reversible?
Helpful - 0
367994 tn?1304953593
I'm not sure where you got the size of AA to be 1.11-1.5cm?.

>>>>> "On internet there are several different "normal average size" measurements by mra of ascending aorta in avearge middle age men ranging from 2.5cm to 3.0cm to 3.5cm. Is ascending aorta measuring 3.5cm normal average size for normal average 50 year old man?"   If anything the diameter is below normal size, and that can be an issue as the heart would be pumping against higher resistance.

Also, the measured values are an estimate, and your values are within the margin of error.  Most importantly the EF estimate of 61% is well within the normal range. Mild hypokinesis has had little or no effect of the heart's pumping ability.

If the hypokinesis is an issue, your doctor should have an answer because it is not reflected in the EF. Usually, hypokinesis is the result of occluded vessels and/or a prior heart attack, heart muscle disease, etc.
Helpful - 0
159619 tn?1707018272
COMMUNITY LEADER
Sam,

Your numbers are not all that bad. Most importantly, your EF% is normal at 61%, that means your heart is pumping 61% of the blood in your left ventricle on each beat, great number. You do have some mild hypokinesis in the septum, the wall between the chambers, meaning that it is lacking some motion, acting lazy. That can be improved with some conditioning or if there is an underlying condition such as blocked arteries which is resolved. Your septal wall measurement of 1.2CM is on the high side of normal as well, you'll want to keep your BP down to control that.

I'm not up on the the aorta measurements, I'm sure someone else will explain that.

Hope this helps,

Jon
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Avatar universal
any help friends?
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Avatar universal
ANy info?
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Avatar universal
hello friends i am back, my doctor said that i had mild hypokinesis of the interior wall..........its written as

LV Systolic Function: 55-60 %. MILD HYPOKINETIC SEPTUM.
EVERYTHING BELOW IS IN CM
If you can plz tell me how is this mildness defined. My chamber size has only 2 readings that r little offset, that are septum (D) (i.e 1.2cm it was suppose to be 0.6-1.1) and the Post wall(d) 1.2cm ( it was suppose to be 0.6-1.1).  Asc Aorta is 2.4 ( it was suppose to be 1.1-1.5)

other readings are
LV systole 2.1 cm
RV (D) 3.5 cm
LV Ejection fraction 61%

Your help will be greatly appreciated, and also if this can reverse
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Avatar universal
<<>>


Yes, being that she was very young (she claims a teenager), it could have worked in her advantage as the heart might have remodeled to adjust to the condition. She said the only thing they told her was that she didnt have to play gym if she didn't feel like it.... but she DID with no ill effects.

I recall many years ago when I was about 20 and having palpitations, a cardiologist told me that although my echocardiogram showed minimal mitral valve prolapse, that I would probably "outgrow" it as I age.   He must have been right because none of my echos years later ever showed mitral problems since then.

My mother's recent echo at age 86 is as follows:
1. right atrial enlargement
2. left atrium dilated 4.66cm
3. Asymmetrical septal hypertrophy was present
4. moderate degree of mitral valve insufficiency
5. mild dregree of aortic insuffiency, tricuspid insufficiency and pulmonic insufficiency
Ejection fraction 60%  
Aortic valve was grossly normal

She claims she was never treated for anything but high blood pressure medication (the beta blocker, Inderal) which she took inconsistantly and this was later in life (50's). In other words, when she "ran out" she simply never went back to get another prescription in a timely manner...not the most cooperative patient still to this day.  She only began on ACE inhibitors (Vasotec) in her late 60's, 70's.  She's had problems with calcium channel blockers in the past, so they are out.

Anyhow, I just thought I'd share one person's rather positive account as I know how worrisome and stressful heart issues can be.

Hope this helps...
Lily




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367994 tn?1304953593
If your mother has had an enlarged heart since a child, she may have developed or must have developed very good compensating factors. Was it the right side of the heart, and what was/is the underlying cause?

A person can live with an enlarged heart anywhere from weeks, to months, to years. In addition to heart size, it is important to know about heart function. If the heart function is well preserved, even though it is enlarged, survival rates are better. Although the heart generally weakens as it gets larger, if found early enough, treatments can be started to prevent or reduce the chance of heart function worsening.  Was your mother treated?
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Avatar universal
The main thing is that from this point on, it's important to do whatever possible to benefit your condition.  It appears you already realize that and are taking steps in the right direction.

As for your concern about a shortened life expectancy.... my mother will be 87 next birthday and doctors have been telling her she has an enlarged heart since she was a child.  On top of that, she's always had extremely erratic high blood pressure (since her 30's) that was never properly controlled no matter what type or how many medications they've tried on her.   Also, she never really took any precautions, she ate what she enjoyed, and lived her life doing anything and everything she wanted to.  She's just one example and of course there are those less fortunate.  I'm in no way promoting throwing caution to the wind, but I'm trying to say don't stress yourself out too much about it.  While I don't know your case personally, I can say that having an enlarged heart does not always mean your days are numbered.

Take care,
Lily
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1 Comments
Have signed up just to thank you for your comment. It is really heartening to hear your mother's story. I am 40 and have just been diagnosed with an enlarged heart, but her story makes me feel very positive.
367994 tn?1304953593
You are welcome, and we would appreciate a followup.
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Avatar universal
Hopefully there is no damage or anything, ill will get back with results, thanks alot for help.
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367994 tn?1304953593
About 6 years ago I had an enlarged heart and low cardiac output due high blood prssure.  Currently may heart is normal size and heart is pumping efficiently. Your heart can enlarge due alcohol and drugs alone. and it would likely cause heart muscle damage, and that condition is difficult or not possible to reverse.

However, you are high blood pressure medication indicates your enlarged heart is due to ischemia (lack of adequate blood supply) to the heart cells.  Ischemia often happens as result of narrow blood vessels, and the heart pumps against higher than normal resistance and that can cause the heart to enlarge.

Dilate the vessels with medication and the workload of the heart is reduced and the heart can return to normal size.  An enlarged heart can also cause heart rhythm problems as well.

An EKG has a low sensitivity rating for issues not related to rhythm disorders.  Your upcoming echo test will provide information regarding heart wall contractility, chamber and wall size, and blood flow through the heart, etc.

The probability of a successful outcome is high, and everything can return to normal.  You and your doctor will have a better understanding of your condition after the echo test.  Thanks for sharing, and you are welcome to post your echo results.  Take care.  

Helpful - 0
976897 tn?1379167602
With your blood pressure lower and your lifestyle changes, it is very likely your heart will recover to its normal size over time. You are wise to stop now before it's too late. When I was in hospital last, I met a guy who was walking around with his heart stopped. He had a battery pump around his waist and his heart was massive through alcohol. It was shrinking, and if it reached a certain size, they would restart his heart and remove the pump. Strange how you all rely on humour in hospital to get through, we nicknamed him the Dalek.
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