Dilated Right Ventricle

[Vea]

I applied for a health insurance and the application was posponed because the echocardiogram which I had done as part of the medical requirements showed in it's report (LVIDD=55.0   Mildly dilated right ventricle)  The company the will reconsider my application after I have been investigated by a cardiologist and the subsequent report is satisfactory.Can you tell me how serious is a condition like what was identified?
The eco. report also stated AO=29.7  Normal size left ventricle with good systolic function. EF 81% LA=43.2  Normal wall thickness. LV diastolic dysfunction, RV=28.8 No wall motion abnormality, IVSD= 5.0 Mildly dilated left atrium., PW=7.6 Structurally normal valves, LVIDS=31.3 Mild TR. RVSP 45mm Hg. and EF= 81% Trivial mitral regurgitation. Normal pericardium.
This all sounds like so much. Will I be all right with treatment after visiting a cardiologist? Will I have to take a lot of medical treatment? I am not accustomed to being ill and this has me a bit concerned, especially with the medical costs of treating heart illness in our country.
I will be 60 years old next month. I can walk long distances without any problems and I sleep well. Can you please advise me?
Thank you,
Liz.

[maggiemag]

Well i am a little confused.  Your title says right ventricular enlargement.  The report references the LVIDD as mildly dilated RIGHT ventricle, but those letters mean left vent, diastolic dimension and the 55 would be appropriate for left ventricular numbers, possibly very mildly dilated.  Your EF is actually elevated at 81% with normal being 55-70%. The left atrium does appear mildly enlarged.  The mild TR (tricuspid regurgitation), and the trivial mitral regurg. are normal.  The RVSP is elevated.  I wonder about the accuracy of the echo.  Was it done by an experienced cardiac sonographer and read by a board certified cardiologist?  Maybe they could just repeat it in 6 months.  You might not need treatment at all, but the good news is that you have no symptoms!  Just make sure you follow up with a GOOD cardiologist.

[Vea]

Hello maggiemag,

thanks for your response but what I have mentioned is exactly what was communicated to me in writing. The letter from the insurance stated exactly what i wrote and was written by the company's medical consultant in a letter. "we posponed your application pending investigation of a Dilated Right Ventricle which was identified on Echocardiogram done on etc,etc." Attached to the letter was the Eco. report from the imaging department which was signed by the cardiologist. The report is exactly as i wrote in my forum letter. All this as i said is new to me i don't understand any of the medical terms. I will, however, get a second opinion by doing another test. Thanks again for your response.

[kenkeith]

The mildly dilated RIGHT ventricle and the LV (end)IDD  is 55 mm (normal is 35 - 57 mm).  The left atrium 5.0 (normal is 36 - 47) exceeds the upper dimension but dimensions are an estimate (the tech attempts to outline a moving, fuzzy looking border with a transducer) and the margin of statistical error is about 10%.  I watched my procedure and was told it is difficult to be exact, and the faster the heart beats the more difficult.

Your EF is somewhat high and again this is an estimate.  A high EF can indicate the heart is compensating and should not be sustained at that level, and probably isn't as you don't have symptoms, etc.  The compensatory EF happens when the heart dilates causing more forceful contractions.  This happens normally to help maintain a balance of blood flow between the left and right side of the heart and just as normal as an increase in heart rate.  

Right ventricle systolic pressure (RVST): the expected value is less than 35.  Above 40 is considered mild pulmonary hypertension.

The questionable results (at the time of test) include a marginally large RA, an EF that is compensating, and an elevated RVSP.  There is an inter-related consequence, for instance, a high RVSP can dilate the right ventricle, and an increase in RA can cause an imbalance between the right and left blood flow that increases the EF.  If there were a serious problem there would be shortness of breath, and a subsequent test may have different parameters and show no problem whatsoever.

[Vea]

Thank you for your very informative information. Much appreciated. I have decided to see a cardiologist and hear what he has to say. The test that was done was at the expense of the insurance company and their affileated clinic as an evaluation for health insurance and was sent to me advising that i have the results investigated by a cardiologist.

Once again thanks. I believe with following medical advice and Gods help this will be will work out right.