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Cause for bi-atrial dilation on echo, question #2

Thanks for answering the question on “any cause for bi-atrial dilation except amyloidosis”, here is more info from 2010-12-13 echo’s. 2013 echo was not compared to 2010& 2012 echo's. I have HTN RX with meds & MGUS(found by accident 3yrs ago but has been stable). I know HTN can cause LA dilation but didn’t think it caused RA dilation without change to the RV. 2010 echo is where abnormalities began

2013 RA mildly dilated, LA severely dilated(dia=4.2cm, vol=97ml, index vol=1.9 cm/m2). 2012 RA normal, LA borderline(no vol, dia=4.0cm). 2010 RA & LA normal (LA dia=3.7cm)

2013 LV size end systole=2.8cm, 2012 LVIDs=2.97cm&2010=3.20cm

2013 LV size end diastole=4.3 cm, 2012 LVIDd=5.71cm&2010=5.45cm

2013 LV post wall thick-diastole=1.1cm, 2012 LVPWd=0.91cm&2010=1.0cm

2013 IV septal wall thick-diastole=1.0cm, 2012 IVSd=0.91cm&2010=0.80cm

2013 LV size, systolic function, wall thickness= normal. LVEF=63%, LV diastolic dysfunction. EKG = LAFB & 1st heart block. 2012 LVEF=70%, mildly reduced LV compliance. 2010 LVEF=71.6%, mildly reduced LV compliance

2013 RV size&systolic function normal. 2012 RV size&function normal.  2010 RV cavity size normal

2013 aortic valve opens well, mild sclerosis, no stenosis. 2010-12 aortic valve structurally normal, no stenosis or significant insufficiency

2013 mitral valve leaflets mildly thickened with decrease in opening excursion & mild annular calcification, no valve prolapse. 2012 clinically insignificant trace mitral insufficiency. 2010 structurally normal, no stenosis, no significant insufficiency

2013 tricuspid valve structurally normal. 2010-12 structurally normal, no stenosis, no significant insufficiency

2013 pulmonic valve not well visualized. 2010-12 structurally normal, no stenosis, no significant insufficiency. 2010 mild tricuspid regurgitation, not clinically significant
1 Responses
Avatar universal
In the presence of MGUS, certainly the diagnosis of amyloidosis has to be entertained. The ventricular walls aren't terribly thick, making this less likely, though not ruling it out.

The right atrium is only mildly dilated, so there's no need to worry too much about that, especially in the presence of normal valves and heart function. The left atrium is severely dilated, likely due to restricted relaxation as a consequence of long standing hypertension.
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