inferoapical & septal hypokinesis

[viji1950]

I am a 60 year old female with no history of heart disese, jogger for 26 years, HDL 65, LDL 60,Triglycerides 35. Had a baseline ecg which showed sinus bradychardia(isnt it common in runners?) exercise echo showed inferoapical & septal hypokinesia with absolutely no symptoms. My cardiologist thinks I have blockages. My BP is low at 100/60. How is it possible to have a blockage with no other causes?

[kenkeith]

I believe there may be some confusion and I have to disagree with the previous post's evaluation. Hypotension is not the issue of any concern as it does not have a role directly with hypokinesis,  and I believe we all agree with that!  

An athlete's has a physical change that is a thickening of the heart wall, thereby a stronger contraction with each stroke...this increase in stroke volume enables a dcrease in heart rate to meet system demand for blood oxygen at rest. It is not pathological due to the alignment of the heart cells different from the pathophysioloical with hypercardiomyopathy heart cell arrangement...but both condition can enlarge the left ventricles.

Hypokinesis is an IMPAIRMENT of heart wall movement and often segmental or it can be global.  Akinesis is loss of heart wall movement and strongly indicates necrotic heart tissue.  I had hypokinesis and the problem was a lack of sufficient blood flow to the heart wall and that portion had some heart wall movement impairment.  Often the heart cells are in hibernation and when supplied with good blood supply are revitalized as what happened in my condition. As stated by jrbon, the doctor it is highly probable there is ischemia (lack of blood flow).  

You should not wait for something to happen, and As I stated in a previous post there can be ischemia without any symtoms. You should have stress test to determine if there are vessel blockage that is causing hyperkinesis.  

Take care and thank you for your response.


Hypokinesis can have other causes such anemia, a congenital hole between heart chambers(ASD) where there is shunting of blood from the right to the left side...right side blood that should go to the lungs some goes to left side and mixes with oxygenated blood.

[cindy707]

Hi Viji i read your post too and tend to agree w . you actually.  It is very common for pro athletes or those in great physical shape to have a very low pulse rate.  Lance Armstrongs resting pulse rate is consistantly in the upper 30's altho that is pretty extreme its not uncommon to have a pulse rate in the 50's and 40's for most athletes because of your conditioning.  The true defintion on bradycardia is...a pulse rate of under 60 however you have to take it in a person by person evaluation and their lifestyles.  Atypically your blood pressure does not fall within the guidelines of hypotension or low blood pressure also due to your conditioning.  I hate it when heart docs say "I think" because my feeling is don't say a thing until confirmation has been made thru testing.  Personally i would not even go there until it has been confirmed and even then i would get a second opinion if not before from a sports heart doc because it is something that they deal w. on a daily basis and are specialists in the field of sports medicine and the heart and what falls within the normal guidelines....have a great weekend viji....................

[viji1950]

Thanks for all of your feed back

[jrbon]

I think that your hypokinesia indicates some isquemic damage.

Now this can be the result of a blockage or a spasmodic contraction or collapse (e.g. by very low BP) of the arteries.

I think that, if you do not have other symptoms (like chest pain), the latest are more probably.

Nevertheless you can have blockade with low BP and good cholesterol. The key is if you have any damage in the endothelial (inner layer of arteries)  or not, and that is normally produced by inflammation and oxidation.

Jesus

[kenkeith]

Yes, an athlete's heart can be below 60 bpm at rest, and an ekg will produce an abnormal report if the bpm is less than 60.

Hypokinesis is a definition for heart wall movement impairment.  And depending on the location of hypokineses there may not be any wall movement that significantly impairs the heart's contractions.  The septum is the wall that separates the right and left chambers and may have verly little impact on the heart's output and no symptoms. But the septum has electrical impulse pathways for the impulses that normally start with the sinus node (heart's pacemaker) in the right atrium and conduct into the ventricles to contract. And if there is damage to the septum there can be arrhythmia (irregular heartbeats), but sinus brady...indicates the heart's pacemaker is slower than normal and that is consistant with an athlete's heart.

Usually, with hypokinesis the underlying cause often is due to occluded vessels that limit the supply of oxygenated blood to heart cells.  The usual symptom with occlusions are chest pains but not always.  Silent ischemia is the medical term for no symptoms, but a lack of blood supply to heart cells never the less.

Hope this helps, and if there are any further questions or comments you are welcome to respond. Take care