Any help deciphering my echocardiogram results?

[Reneestac]

so worried and concerned. Any help would be so appreciated. I've been having palpations. My resting heart rate can be in the 70s when laying down, sitting up it raises to the high 80s lows 90s. Then walking I'm in the 100+ or walking up stairs or any activity can put me well above 115 sometimes as high as 140. I believe the highest was 160 at one point. The moment I sit or lay the down the HR comes down. I can't tell if I am having shortness of breath but I find myself taking deep breaths and when I am conscious of my breathing I almost feel like I can't take in enough oxygen.  I've had several ekgs and they were normal. I wore a holter monitor for 48 hours and it was read as all sinus tachycardia and some ectopic beats. I did just have a baby 5 month and 3 weeks ago. I have so many questions and I've called my doctor, cardiologist, and he doesn't seem too concerned. But this is very scary for me, I am 5'1" and 115 lbs. I try to eat healthy, I don't drink or smoke. I am 31 years old. Not sure why my heart would be having these issues. Is this considered heart failure? If my heart is structurally normal, what is causing the ejection fraction to be low? How is heart failure diagnosed? Is it just the ejection fraction alone that determines HF? Is it reversible?
What other tests do I need? Is this going to shorten my lifespan? Is it possible that this is going to end my life? Will my ejection fraction worsen? What can I expect in the next weeks, months, years?
What should I be doing to improve or help my condition
Is it possible that I have ischemia? Or coronary artery disease?
Eating habits? Exercise? Restrictions? Feeling like I may puke every second, I have no appetite. Am I going to develop more symptoms and progress to risks of developing ventricular tach or fibrillation? Why is it a range from 45-50%?
Should I be in a cardiac rehabilitation program? What would be the best medication possible? I am experiencing the chest pain still along with shortness of breath. Sorry for the bombardment of questions, I am just so very scared. I really do appreciate your comment and response. I know I have these are questions I must ask a doctor but any advice at all, I would be so grateful. Thank you.
Home » Health Record » Imaging Reports » CV ECHO WO CONTRAST - 01/06/2016
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CV ECHO WO CONTRAST - 01/06/2016
CARDIOLOGY
ECHOCARDIOGRAPHIC AND DOPPLER REPORT

Physician Dictating Procedure:  Michelle A. Consolini, MD
HEIGHT:  61 inches
WEIGHT:  115 pounds
REASON FOR STUDY:  Palpitations

Date of Study:  January 6, 2016

Technical Quality:  Adequate
Previous Study:  None

M-MODE MEASUREMENTS:
IVSd (0.6-1.1): 0.86 cm
LVPWd (0.6-1.1): 0.82 cm
LVIDd (3.5-5.7): 4.4 cm
LVIDs (2.3-3.9): 2.8 cm
FS: 37.9 %
EDV(Teich): 89.6 mL
Ao root diam (2.0-3.7): 2.6 cm
LA dimension (1.0-4.0): 2.5 cm
EF(MOD-sp4): 53.5 %
EF(MOD-sp2): 61.0 %
SV(MOD-sp4): 48.6 ml
LA A2 area: 12.1 cm2
LA A4 area: 9.8 cm2
LA vol (12-52 ml): 26.2 ml
LA vol index (16-28 ml/m2): 17.5 ml/m2

Pericardium:  There is no pericardial effusion

DOPPLER MEASUREMENTS:
MV Peak E: 59.6 cm/sec
MV Peak A: 44.9 cm/sec
MV E/A: 1.3
MV dec time: 0.20 sec Ao V2 max: 113.8 cm/sec
Ao max PG: 5.2 mmHg
Ao mean PG: 2.8 mmHg
AoV V2 VTI: 25.6 cm
PA V2 max: 59.2 cm/sec
PA max PG: 1.4 mmHg
TR max vel: 141.6 cm/sec
TR max PG: 8.0 mmHg
RVSP(TR): 13.0 mmHg

Mitral Valve:  Structurally normal
Aortic Valve:  Opens well, structurally normal
Tricuspid Valve:  Structurally normal
Pulmonic Valve:  Structurally normal


INTERPRETATION:
2-DIMENSIONAL STUDY FINDINGS
The aortic root is normal in size.  The left ventricle is normal in size.  RV systolic function is normal.  The right atrium is normal in size.  The left atrium is normal in size.  LV function is mildly reduced.  EF is 45%-50%.  There are no regional wall motion abnormalities.  The IVC collapses.  The aortic arch is grossly normal.

COLOR/DOPPLER FINDINGS
No aortic stenosis.  No aortic insufficiency.  There is no mitral stenosis.  Trace mitral regurgitation.  Trace tricuspid regurgitation.  No pulmonic stenosis.  Trace pulmonic insufficiency.  LV filling pattern is normal.  RV systolic pressure estimate is 15-20 mmHg which is normal.  Color Doppler examination of the interatrial septum suggests a tiny left-to-right shunt.  

FINAL IMPRESSIONS:
1.  Normal left ventricle size, mildly reduced systolic function.  The ejection fraction is 45%-50%.  There are no regional wall motion abnormalities.
2.  Right ventricular systolic function is normal.
3.  Left ventricular filling pattern is normal.
4.  There are no significant valvular abnormalities.
5.  Right ventricular systolic pressure estimate is normal.
6.  Color Doppler examination of the interatrial septum suggests the presence of a tiny interatrial shunt; this is an incidental finding.

[tacolino]

Glad you are getting some comfort in the general advice we can offer you. I think you also have a little bit of guilt that things are going so well for you since you had your baby!!!. But look, life is great for you, new baby, great results with your heart tests. Hope you can move forward positively. Kind regards, try keeping your mind off your health anxiety and on the positives

[Reneestac]

You have no idea how much your words have comforted me. You and tacolino have really helped to make this a little easier on me. It is very scary, I do feel like I am having major health anxiety. Having such a precious little baby has made me feel so much happiness that I almost feel like it's too good to be true. I even ask myself if I deserve to be this happy, maybe that has been fueling some anxiety. I really do appreciate your words of comfort. I wish my doctor would have some openings in his schedule sooner in order to help me better understand. Thank you. You really have been very kind.

[achillea]

I remember being a young mom to a baby just about the age of yours (and congratulations on having an amazing baby!), but I also remember an overwheming fear that I had never experienced before:  I suddenly realized that I was responsible for the entire well-being of this little human--and what if I should fall ill or die???

This was a big deal, a really big deal, and it did cause me some health anxieties for a while.  In the years since then, I have read that this is not exactly unusual in new mothers.

Since your radiologist's report is essentially normal--and it really is--I think it would be a good idea to talk with your doctor about the possibility that anxiety attacks may be partly responsible for many of your symptoms.  Personal experience has taught me this is truly possible.

Yes, your ejection fraction appears to be just a teeny bit low--just a wee bit--but hemodynamics (heart action, chamber size, blood volume, etc) are known to be unstable in new mothers.  And yes, you have a very small septal defect, so insignificant that it was discovered by accident.  It is good to know about these things, primarily so you can just keep an eye on them, but these little abnormalities do not explain your symptoms of distress.

Please do consider the possibility of huge, semi-normal though unexpected worry about not being "there" for your lovely baby.

You will be there for him.  

[Reneestac]

Thank you so much for your response! I am so happy to hear that you got your EF up from 20%! How were you able to increase your ef?? I've never had high blood pressure, not even during pregnancy. I'm really not sure what would be causing my ef to be low :( that is why I am so scared. I'm not sure if I should be doing something right now to prevent it from dropping lower. Why are the numbers in range? Wouldn't it just be one or the other? I'm scared of what I should or should not be eating or doing activity wise. Thank you so much for your kindness to take the time to write a response. My little one is amazing! He is such a good baby!! Your words have helped me so thank you again!

[Reneestac]

Thank you so much for your response! I am so happy to hear that you got your EF up from 20%! How were you able to increase your ef?? I've never had high blood pressure, not even during pregnancy. I'm really not sure what would be causing my ef to be low :( that is why I am so scared. I'm not sure if I should be doing something right now to prevent it from dropping lower. I'm scared of what I should or should not be eating or doing activity wise. Thank you so much for your kindness to take the time to write a response. My little one is amazing! He is such a good baby!! Your words have helped me so thank you again!

[tacolino]

Hi there. I am not a doctor but can offer general advice. Firstly your results are great! All valves are normal. Both ventricles are normal. Your EF is slightly reduced, but 45% - 50% is only slightly reduced, given that the normal approximate range is 55% - 65%. You seem really scared. That's understandable given that you just had a baby last year. I think you may have a little anxiety and this has caused a bit of paranoia to creep in too! If the doc had any further concern he would have suggested an Angiogram test or even a stress test. I presume your BP is normal?? If it was raised during your pregnancy, it could be a reason for the slightly reduced EF. It does sometimes improve, but it happens over time. I had a Hypertensive crisis 2 years ago. My Systolic at ER was over 250 mmhg! and echo showed EF less than 20%. It has come back to 45% now, having got the BP under control. You should write down your concerns and go back to the doc. I think he will be able to re assure you regarding your heart. Hope this is of some help to you.  PS Hope the baby is not keeping you awake too much at night!!