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Doctor said my heart is healthy. Just making sure please

So I am a 30 year old male and I went to the cardiologist because I kept getting sometimes intense chest pains on my left side of my chest so naturally I thought I was having a heart attack all the time. So went to the cardiologist who has 35+ years of expierence and he did blood work, stress test, multiple ekgs and a echocardiogram. I got the results and he said my good cholesterol is a little low and I need to just get that up but other then that blood is fine. Even though I could only go 8 minutes on the stress test because I am so out of shape (lol) my ekg on the stress test was perfectly normal.

The test result of my echocardiogram looked almost completely normal and the doctor said he is 100% for sure to not be alarmed with my heart and scratched his head when I even asked if I should come in for a follow up. But when I was reading the test results I just have a few questions. What do the following mean.

1. Aortic valve leaflets mildly thickened
2. Mild thickening of mitral valve anterior leaflet
3. Minimal tricuspid regurgitation
4. Physiologic pulmonic valve regurgitation

Are any of those alarming. All my valves and chambers and walls are perfect. No stenosis or anything alarming he said.

Also a palpitation is when your chest feels like it’s fluttering and it’s going extra fast right? Why do I seem to get one a day sometimes 2 and sometimes I don’t get them for weeks. I am on amitriptalyne and omeprazole every night.

Also average bp is 130/90 little high but doctor said it’s not alarming yet.

I just want to make sure I’m not going to die in my sleep due to a heart attack. Should I trust the doc?

Also the doctor said the only abnormality with my ekg was a little electricity was off. The nurse scared the crap outta me and told me it looked like I had a heart attack before which I heard is a big no no for a nurse to say, when I asked the doc he’s like oh no no no you never have.

The chest pains turned out to just be muscular skeletal.
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20748650 tn?1521032211
None of those things are overly concerning..

The tricuspid and pulmonic regurg is a normal variant found in a large percentage of the population.. Everyone has it to some degree if you look hard enough.

The valve thickening is a mildly abnormal finding and could be related to alot of things.. For example an early childhood illness could have done it, or you could have just been born that way.

The valves are like doors.. As long as they can open and close ok, then there is no issue. Any significant impaired function of the valves would have been clearly visible on the color doppler (which was done appropriately because they found the right sided regurg) or it would have been evident from a subsequent cardiomyopathy (muscle too thick or thin).

Any emergency room doc or cardiologist would have been able to see some evidence of a prior heart attack. So i think that was likely an accurate assessment.

On the other hand however i think you could benefit from a few,more tests.. You can call the cardiologist and ask for a 'holter monitor' for your racing heart rate.. That could be pathologic.. But not likely serious mind you, so no need to worry too much.

But yes.. Episodes of fluttering is something cardiologists should have an interest in investigating.. Assuming you didnt share this your last visit?

Additionaly;

They didnt pick up any tachycardias when you stood on the treadmill so that can kind of rule out some common options. Post recovery pvc burden was likely low or they would have brought that up.. Having a mostly normal ett often makes holter findings more exciting.

The second issue i see in your story is your functional capacity..

Did they happen to mention if the speed of the treadmill increased every 2 minutes or 3? If the answer is 3 then you need to improve your functional capacity (fitness level) or youre gonna find yourself having a heart attack for real!!

At your age you should absolutely be able to complete 3 stages (9 minutes) on a treadmill no problem.. Honestly id lobe to see you do at least 4..

If however they used a modified bruce (2 minute stages), then 8 minutes is about average.
Helpful - 1
2 Comments
Thank you so much for your response. I did 4 2 minute runs on the treadmill. It was more my legs getting tired then me actually needing to stop I could’ve gone prolly 4-6 more minutes. Yes I am out of shape but I am working on it with the wife.

I told my doc about the fluttering and he told me not to worry about it. Tomorrow if I remember I will post the entire echocardiogram results.

My doctor assured me that I am ok and I have never had a heart attack, I have health anxiety so I believe him but sometimes my Brian says what if he forgot something. Nicest guy I have ever met and said I have nothing to worry about.

I asked if I had a chance of dieing in my sleep and he said he can never rule it out because it can happen to the healthiest but he said in your case right not do not worry I am overall a healthy semi overweight male.
I see..

Well 4 stages on modified bruce (2 min) actually isnt half bad! So thats not so much of a problem.. It sounds like your fitness plan is probably a good one.

If they were doing the 'standard' 3 minute protocol then you would have still been in that slow walking pace (the third stage) when you quit at 8 minutes.. It makes a difference for sure.

As for fluttering.. Agree with your doc completely you probably don't need to worry about..

Palpitations like that are rarely dangerous.. Its just something that they can diagnose and treat. For some patients the simple knowledge that we saw it and know what it is offers some peace of mind

Its a bit challenging mind you to actually get a patient to have a palpitation while they're wearing the holter (basically an ecg you take home for 24 hours).. Cases like yours are the worst for this.. Because they go away for weeks at a time the stars sort of have to allign to make sure they dont go into hiding when we're lookin for them!

***But!!*** With a bit of luck we can spot it and offer the patient some medicine to help reduce the frequency/duration of the palpitations if they want it.

Some types of palpitations can be treated through an invasive procedure called an "ablation" as well.. Quick easy zap and sizzle with a little radiofrequency energy and the patients right as rain :)

Of course neither you nor your doctor sound overly concerned with it.. And y'know If its something you can tolerate, chances are you'll be fine in doing so.. As stated earlier most sources of palpitations are beningn and treated mostly for patient comfort.

Ill look forward to seeing your echo tomorrow, but for tonight you should be pretty stoked everything came back pretty normal!
Avatar universal
No I am not a smoker nor do I have any of those diseases. I have health anxiety so that’s why I am
So nervous. I just celebrated my one year anniversary and my number one fear is leaving my wife alone on the World if I die in my sleep. My chest hurts whenever I talk about this but it feels like it’s in the skeletal mUscular section. Yes I could work out more  I am 207 pounds and 5”10. The doctor said I shouldn’t worry at all and he didn’t even think I needed a follow up. He was an Indian doctor with 35+ years expierence which I trust. I just wanted another opinion without going to the doctor again since I don’t have health insurance at the time because I got a new job so In the limbo period.

Do you overall think I am set to have a good long life :)
Helpful - 0
Avatar universal
Findings:

Left Ventricle: Lv chamberr and wall dimensions are normal. There is normal LV systolic function.  There are no wall motion abnormalities.  The estimated LV ejection fraction is normal at 55-60%. Left ventricular diastolic fucntion is normal.

Right Ventricle: There is nornal right ventricular size, wall dimension, and systolic function.  No RVOT obstruction noted.

Left Atrium: LA chamber size is normal.

Right Atrium: RA chamber size is normal.

Aortic Valve: There is a trileaflet aortic valve.  There is normal aortic valve structure and function.  There is no aortic valve stenosis or regurgitation.  The aoritc valve leaflet is mildly thickened.

Mitral Valve: There is normal mitral valve structure and function.  There is mild thickening of mitral valve anterior leaflet.  There is minimal regurgitation.  There is no mitral stenosis.

Tricuspid Valve: Tricuspid valve is structurally normal.  There is no tricuspid valve stenosis or regurgitation.  There is muld tricuspid regurgitation.

Pulmonary Valve: There is normal pulmonic valve structure and function.  There is physiologic pulmonic valve regurgitation.  There is no pulmonic stenosis.

Pericardium: There is no pericardial effusion present.

Aorta: The size of the visualized portion of aortic root is within normal limits.



Impressions:
-There is normal LV systolic function
-The estimated LV ejection fraction is normal at 55-60%
-Normal right ventricular size and function.
-There is mold tricuspid regurgitation


M-Mode      ECHO DIMENSIONS

Ao Root Dia       (2D 3.37cm)  Range (2.0-3.7)
LA Dimen          (2D 3.39cm)  Range (1.9-4.0)
IVS (D)              (2D 0.89cm)  Range (0.6-1.1)
LVPW (D)         (2D 0.95cm)  Range (0.6-1.1)
LV (D)               (2D 4.92cm)  Range (3.5-5.6)
LV (S)               (2D 3.53cm)  Range (2.1-4.0)
LA Vol Idx         (2D             )   Range (<35)
Asc Ao Dia      (2D              )  Range (<39)
RVID                (2D             )  Range (2.7-3.3)
LVOT Dia        (2D 2.26cm)   Range (1.8-2.2)
Av Opening     (2D 2.13cm)   Range (1.5-2.6)
EF                   (2D 55.2%)     Range (50-90)
FS                   (2D 28.25%)   Range (25-46)
RVSP              (2D 25.1 mmHG) Range (15-30)


DIASTOLOGY

MV E        0.61 m/s     E'Med     10cm/s
MV A        0.54 m/s     E/Lat E'    4.36
MV E/A    1.13 (none) E/Med E'   6.1
MV Dec T  222ms   Tv Med E' Vel
E'Lat        14 cm/s   Tv Lat E' Vel


DOPPLER

AVvel      1.09 m/s     LVOTvel.    1 m/s
Pk Grad   4.48 mmHg   Mn Grad   3.1 mmHg
AVA(pk)    3.68 cm2    AVA(VTI)
AI PHT                        RVP       25.1 mmHg
PV Vel     0-83 m/s     TR Vel    1.94 m/s
                                    MPAP
                                    PVAT


Wow that was a lot to type out.  Are you a cardiologist as well?  The fluttering I get is because the doctor said my electricity is a little off that's why the nurse thought i might of had a heart attack in the past. Isnt this Arrithmyia?

Am I going to be ok?

Helpful - 0
1 Comments
Physiologic pulmonic regurg... How non descriptive lol.. Regardless it probably isnt severe or they would have told you. You dont have any severe asthma or copd/emphysema.. anything like that youre worried about? Are you a smoker?

Reason i ask is this tends to be a normal finding in most patients but can create problems if combined with some sort of debilitating lung disease.


As for the fluttering yes, its likely an arrhythmia.. Dont wanna beat a dead horse on that one.

As stated in previous posts if you wanna go just off statistics then yes youll be ok. Its kind of a loose end though..

I can see the logic.. Its not the primary problem you came to the doctor about, and the odds are its not dangerous. Yet.. I find it a tad odd they didnt at least suggest an attempt at tracking it down and tieing up that loose end... Unless of course you didn't mention it at your appointment.

Finally, no im not a cardiologist, sorry. Just an allied professional specializing in cardiology, my particular focus being cardiac electrophysiology (heart rhythm).
Avatar universal
The palpitations arrithmyia scare me when they happen but the doc said that almost everyone has electricity problems with there heart and to not worry st all.
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