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Concern: Marked right atrial enlargement
There is a lot of background information, some in my profile, which I will not repeat here.
I had my 3 year follow up echocardiogram a couple of weeks back and my wife got a telephone call from a support person at my cardiologist's office. I wife passed on to me the echo evaluation: No problems, no changes. As always I get a copy of the report mailed to me for my evaluation.
One change I see is the summary statement under "Impressions": Moderate tricuspid regurgitation with marked right atrial enlargement.
Checking my files, I have not seen this pointed out before. There is nothing in the data field provided quantifies this statement. I am in permanent AFib and the left atrium continues to be measured and characterized under the "Impressions" as: Left atrium enlargement. No descriptive terms like "marked". The left atrium measurement is also provided and that number is approximate the same as previous measurement.
I think I will call my cardiologist next week and ask about the "marked right atrium enlargement" impression. There are other marginal conditions including notice of left ventricular wall thickness at upper limits of normal. This part of the report seems to be more "data" and did not by itself cause any impressions.
On the good news side, my mitral valve repair seems to remain effective (but no effort has been made to me to explain why my left atrium has not shrunk toward normal following the MV repair. I am a senior and was when the MV was repaired so my body doesn't make repairs that may occur in a younger body. That said, my heart surgeon said even at my age there could be some shrinking of the left atrium following the repair and that could lead to reduction in AFib. He also did a mini-maze while my heart was open and gave it about a 60% chance of stopping AFib, it did not.
I tried not to give my complete background as many here may recall them from my past posts.
My reason for making a post is for comments about a "marked" right atrial enlargement.
I had my 3 year follow up echocardiogram a couple of weeks back and my wife got a telephone call from a support person at my cardiologist's office. I wife passed on to me the echo evaluation: No problems, no changes. As always I get a copy of the report mailed to me for my evaluation.
One change I see is the summary statement under "Impressions": Moderate tricuspid regurgitation with marked right atrial enlargement.
Checking my files, I have not seen this pointed out before. There is nothing in the data field provided quantifies this statement. I am in permanent AFib and the left atrium continues to be measured and characterized under the "Impressions" as: Left atrium enlargement. No descriptive terms like "marked". The left atrium measurement is also provided and that number is approximate the same as previous measurement.
I think I will call my cardiologist next week and ask about the "marked right atrium enlargement" impression. There are other marginal conditions including notice of left ventricular wall thickness at upper limits of normal. This part of the report seems to be more "data" and did not by itself cause any impressions.
On the good news side, my mitral valve repair seems to remain effective (but no effort has been made to me to explain why my left atrium has not shrunk toward normal following the MV repair. I am a senior and was when the MV was repaired so my body doesn't make repairs that may occur in a younger body. That said, my heart surgeon said even at my age there could be some shrinking of the left atrium following the repair and that could lead to reduction in AFib. He also did a mini-maze while my heart was open and gave it about a 60% chance of stopping AFib, it did not.
I tried not to give my complete background as many here may recall them from my past posts.
My reason for making a post is for comments about a "marked" right atrial enlargement.
COMMUNITY LEADER
I telephoned my cardiologist and left a message. He called me back about 4:30 pm, assume he makes these calls "after hours" before going home.
He said there was nothing threatening about the right atrium enlargement and that there were no underlying problems that would cause it to continue to grow. He then said he had given the echo results a careful study before determining the diagnosis "no change". The choice of word "Marked" was that of another cardiologist who was "on duty" at the testing center. I think all the cardiologists in the practice (must be at least 8 of them) take turns overseeing the testing center.
I'd still like to get back to normal sinus rhythm, but it appears I'll need to change cardiologist if I want to open that subject again... unless something new comes along as has been pointed out elsewhere by DeltaDawn.
He said there was nothing threatening about the right atrium enlargement and that there were no underlying problems that would cause it to continue to grow. He then said he had given the echo results a careful study before determining the diagnosis "no change". The choice of word "Marked" was that of another cardiologist who was "on duty" at the testing center. I think all the cardiologists in the practice (must be at least 8 of them) take turns overseeing the testing center.
I'd still like to get back to normal sinus rhythm, but it appears I'll need to change cardiologist if I want to open that subject again... unless something new comes along as has been pointed out elsewhere by DeltaDawn.
Jerry -- I have been trying to comment, but even having changed my password a couple of times, medhelp was not letting me on. My echoes came back with a thickening of the atrial wall and left atrial enlargement and there seemed to be little concern about it. I believe it is a consequence of the afib. That said, I would definitely ask your doctor for an explanation of the right atrial enlargement and its significance, if any. That is a reasonable request. It is your body, your money being spent on testng and you are the one with most at stake. Good luck with this. Let us know what you find out.
As mentioned earlier, a right atrial enlargement may be a sign of increased pressure in the pulmonary arteries, but if so, your right ventricle would probably also be enlarged.
As you said, in permanent atrial fibrillation, the atria are really not doing much, they don't contribute to any filling of the ventricles.
Atrial fibrillation can cause both right and left atrial enlargement, but an already enlarged left atrium (while still in sinus rhythm) is a more severe risk factor for atrial fibrillation than an enlarged right atrium.
I would recommend that you ask your doctor to compare the echos and see if this right atrial enlargement has suddenly progressed or not. If not, this is likely just a normal consequence of atrial fibrillation.
As you said, in permanent atrial fibrillation, the atria are really not doing much, they don't contribute to any filling of the ventricles.
Atrial fibrillation can cause both right and left atrial enlargement, but an already enlarged left atrium (while still in sinus rhythm) is a more severe risk factor for atrial fibrillation than an enlarged right atrium.
I would recommend that you ask your doctor to compare the echos and see if this right atrial enlargement has suddenly progressed or not. If not, this is likely just a normal consequence of atrial fibrillation.
http://www.ncbi.nlm.nih.gov/m/pubmed/2144217/
Jerry here it says that an enlargement of both atriums can occur as a result of a-fib. I wouldnt worry although a follow up with the md is likely in order. Though here it is presented as a normal and benign consequence of a-fib.
Hang jn there buddy
Jerry here it says that an enlargement of both atriums can occur as a result of a-fib. I wouldnt worry although a follow up with the md is likely in order. Though here it is presented as a normal and benign consequence of a-fib.
Hang jn there buddy
COMMUNITY LEADER
Thanks,
My concern is aggravated by the fact I have 4 echo results from the last 6 years and none of them mention "enlarged right atrium" let alone "marked" enlargement until the one last month. The enlarged left atrium remains rather constant except for one echo following the repair of my mitral valve in November of 2007. I was hopeful that the repair was resulting in a shrinking back toward normal. That wasn't the case, it seems the echo accuracy isn't good, not even good repeatable results. I had the same technician for all echo tests. All subsequent echo tests measurements give approximately the same measure for the left atrium.
I have never had high blood pressure (except what the left atrium experienced when I had a leaky mitral valve), and I've been on beta blockers for years which pushes my BP even lower. So there is no unusual pressure working on the atrium chambers.
As mentioned I suffer from permanent AFib which means the atriums are not doing much blood pumping.
My concern is aggravated by the fact I have 4 echo results from the last 6 years and none of them mention "enlarged right atrium" let alone "marked" enlargement until the one last month. The enlarged left atrium remains rather constant except for one echo following the repair of my mitral valve in November of 2007. I was hopeful that the repair was resulting in a shrinking back toward normal. That wasn't the case, it seems the echo accuracy isn't good, not even good repeatable results. I had the same technician for all echo tests. All subsequent echo tests measurements give approximately the same measure for the left atrium.
I have never had high blood pressure (except what the left atrium experienced when I had a leaky mitral valve), and I've been on beta blockers for years which pushes my BP even lower. So there is no unusual pressure working on the atrium chambers.
As mentioned I suffer from permanent AFib which means the atriums are not doing much blood pumping.
Right atrial abnormality could be due to Pulmonary Hypertension, Tricuspid Stenosis, Lung Disease of some sort.
It could also mean absolutely nothing, particularly if it has been present this whole time without any significant symptoms. I know quite a bit about this as I had the result on 2 EKG's and freaked out. The cardiologist assured me that even if I had it he would want to do further investigation but still wouldn't be worried.
It could also mean absolutely nothing, particularly if it has been present this whole time without any significant symptoms. I know quite a bit about this as I had the result on 2 EKG's and freaked out. The cardiologist assured me that even if I had it he would want to do further investigation but still wouldn't be worried.
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