hypertorphy

[wildcat27]

After my dad (45 year smoker) underwent triple bypass and was diagnosed with CHF and 20% EF (he seems to be recovering well)...I decided to review my prior cardiac records, because I am without question a hypacondriac. I had a lone episode of paryoxsimal A-Fib in July 2006 and have mild MR...have always been told that echos reveal a structurally normal heart. EF has ranged from 55% to 67% on several echos between March 2006 and November 2007.

At any rate, I reviewed some echo readings from November 2006 and May 2007 today and noticed that while my systolic and dystolic functions are in normal ranges, my IVSd went from 1.1 to 1.3 and my LV posterior wall measurement went from 1.0 to 1.1.  I realize these findings are normal to only slightly abnormal...but how concerned should I be about this progressing...how bad could it have gotten since 2007.  

[wildcat27]

Ken,

The readings on the Nov. 2007 stress echo (the last of 5 echos I had between March 2006 and Nov. 2007) stated...

Volume 86 ml [1]

EDV 95 ml [8]

ESV 31 ml [4]

EF 67%

then in  another box of numbers below it says

Chamber 71 ml
Wall 161 ml
Defect 0 ml

I guess my concern is that I've been exercising pretty regularly since this Nov. 2007 test and want to make sure I have not been inducing (for lack of a better word) LVH. Does that make sense.

Can you have normal response to exercise with poor dystolic or systolic function? My understanding is that you can have normal exercise response with LVH by itself.

Thanks for all of your good insight.
Best.

[kenkeith]

Protocol for heart patients or an assessment of an effective heart's functionality would be to consider the heart wall dimensions. And on subsequent tests there should be a reference to prior tests.  Consideration may include whether the increased or decreased size are within a margin of error, etc. and of no concern.

"I don't see LV measurements for that test." I don't know if I answered your question because there should be measurements shown on the report...Howevrt, sometimes there is a stress test with just an EKG and wall dimensions are not provided.  The test is a perfusion test that observes blood flow and looking for any blockages.

Ken

[wildcat27]

Thanks Ken. Very helpful info.

Couple additional questions.

I had an additional stress echo in nov 2007. I don't see LV measurements for that test. If there were changes at that time would the reviewing physician have looked at that.

Also. I exercise regularly without incident. Any concerns about that.

Thanks so much.

[kenkeith]

Your LVPW is within the normal range of 0.6 - 1.1.  

Your intraventricular sepum (wall that separates the left and right ventricle) is mildly increased in thickness, however, it is within the the margin of error of 0.1 cm, and there can be benign wall motion artifacts and/or variations in operator images....and it is an estimate!  

Your EF is well within the normal range indicating the heart wall motion has no impairment and is functioning well in the pumping phase. We know that if the heart wall sizes increase this can reduce the blood filling (smaller capicity) in the left ventrical chamber and if and when the enlarged walls thicken, the thickened wall(s) do not stretch/well very well and that also reduces filling capacity.  I'm providing a perspective for worst case scenario, and your report does not indicate any problem.

You shouldn't be concerned, but it is wise to consider any genetic connection and watch for any irregularities.  Thank you for sharing, and if you have any further questions or comments you are welcome to respond.  Take care,

Ken