true conditions of the heart

[len2]

49yrs old, female here. presently working..
the result of my recent dobutamine stress echo on baseline 2d echo doppler were the ff
1.concentric left ventricular hypertrophy with normal contractility and systolic function but with impaired relaxation
2. dilated left atrium but with normal volume index
3. dilated proximal ascending aorta
4. aortic regurgitation 1+
5.trivial mitral regurgitation and tricuspid regurgitation
6.normal pulmonary artery pressure.
my cardio did not explain further wat does it mean in laymans word so im asking for a further explanation on the result and wat shud i do further, shud i be worried about this, shud i skip my nightime duties for this reason. my cardio just told me to continue taking all my maintenance medication(losartan 100mg, simvastatin 10mg, atenolol 50mg,norvasc 10mg, aspilet 80mg) but i hope somebody out there wud be kind enough to tell me on what further can i do to at least protect my heart
thanks and hoping someone cud giveme some advice..

[Jack54]

1) "but with impaired relaxation" indicates Diastolic Dysfunction.
2) It appears your Left Atrium is slightly enlarged, but the stress echo indicates normal volume. I would ask for a non-stress or normal echocardiogram to better measure your LA.
3) At the very beginning (proximal) of your aorta, directly behind your aortic valve, it appears to be slightly enlarged.
4) "aortic regurgitation 1+" means that you have mild aortic regurgitation. AR is when your aortic valve leaks and allows blood pumped to your body by your left ventricle, to leak back into your left ventricle. This increases the "after load" on your heart and your heart requires more energy to function, proportional to the degree of leakage. All of your medicines should work to lower the after load on your heart.
The dilation of your aorta may have caused this aortic valve leakage.
5) "trivial mitral regurgitation and tricuspid regurgitation" This is a very common finding and nothing to worry about. I have read that 40% of people have this.
6) "normal pulmonary artery pressure" Your PA routs de-oxygenated blood, or spent blood to the lungs where CO2 is exchanged for O2. Your pressure is good :)

Make sure that you keep your blood pressure and heart rate low. Stay away from salt. Read about Diastolic Failure. I have it.

Always get a copy of the actual echo results, so that you can follow the changes in the dimensions of your heart. This is one way that you can tell if your medicines are working, I think.

If your Aortic valve leakage increases, you will have symptoms, if you do not already. In this case you will have to stop working until the valve is replaced or repaired. Your activities will be limited also, or you can further enlarge your heart.

Take care :)

Jack

[len2]

thanks for this,it was very enlightning and helpful, when can i have a ff-up on my echo results, i have recently taken this on oct25,  if my aortic valve leakeage increases what symptoms would i feel? what is the best weight i cud have? i weigh 160lbs now and i stand 5'4..before im 166lbs. i regularly taken  my medications only  july of this year. i hope im not asking for too much..but its one way i cud feel safe.

thanks in advance..

[Jack54]

Knowing how serious aortic valve leakage is, you should get your cardiologist and insurance company to determine how often you can have echos. The thing is, if you do not lose weight and have a good cardiologist that knows how to treat you medically, and you take the medicine religiously, the echos will only show degeneration of your 2 conditions. Aortic valve leakage and Diastolic Dysfunction.

Ask your doctor about exercise now while you have mild leakage in combination with diet to lose down to your ideal body weight, which is probably around 130 lbs? If the valve leakage gets really bad, you will not be able to exercise until the valve is repaired or replaced, which is a common procedure, but requires major surgery. More modern, less invasive surgeries are being developed I believe and the Cleveland Clinic is pioneering break through surgery.

The symptoms of severe aortic valve leakage is extreme fatigue along with other symptoms that I am in no way qualified to list. Most people are hospitalized at this stage and have the valve repaired/replaced. Lots of blood that is pumped up and out of your heart, to the aortic arch above your heart, drains back down into the heart through the leaking valve. So your heart is "spinning it's wheels" and wearing itself out. I have been describing severe aortic valve regurgitation or leakage, not mild leakage like you have.

You won't need an echo to tell you if it is getting worse. You will start to lose energy and not be able to do the things you once were able to do.

The only way the degree of diastolic dysfunction can be measured is during a cardiac catheterization. The left ventricle end diastolic fill pressure (LVEDP) is measured and anything >20 mmhg is considered diastolic failure. In Europe it is anything > 16 mmhg, the last I read. It seems they are more conservative.

An echo can measure the E/A wave ratio which as it increases as a fraction means the left atrium is becoming less able to compensate for the left ventricular hypertrophy.

I have told you some really bad stuff today. Heart disease sucks. But remember that I am just a chukklehead that had a heart attack and stroke in 2003. I have diastolic heart failure, an enlarged left atrium and will have coronary artery bypass soon. My angina gets worse each day. I have had the maximum number of stents in my LAD already.

You can take my info and become so depressed that you can't get out of bed, or you can realize that if you do all of the right things, you could reverse some of your problems and live to be 100, ONLY if you look at it as a challenge. Depression kills.

Best of health and spirits to you :)

Jack

[len2]

thanks again for responding to my queries,

before i decided to see a cardiologist i have symptoms like fatigue,chestpain, shortness of breathing, hardly cant walk upstairs, there was a feeling of lightheadedness, headache,fainting and feeling like vomitting. my bp is somewhat like 180/120. im just glad nothing serious happen to me,

i had 3 ecg results which bear all the same findings then, old inferior wall myocardial infarction, left axis deviation,left atrial enlargement,left ventricular hypertrophy. im just curious our company doctor didnt recommend that i shud  take a rest or long leave inspite of this.

well i hope ull be ok with ur coronary bypass surgery then

as u say, heart disease realy sucks but its better to stay alive

thanks again for ur time.