EKG results vs. echocardiogram

[corkster]

Two years ago, based on a x-ray taken for a shoulder injury i was told I hand an enlarged heart and that I had the precursor to diastolic heart failure.  I sought a second opinion and was told that no one can diagnose an enlarged heart from a "two dimensional" picture (i.e. x-ray?).   EKG and echo cardiogram/echo stress tests were performed.  The cardiologist ruled out an enlarged heart. He said that the EKG was "abnormal" in that it indicated I had had an anterior infarct but that the echocardiogram did not show that to be true.In the end I was told I have aortic valve insufficiency and no constraints on my activities.

I am an avid walker and can hike 4-6 miles at 8300 feet. I am considering trekking between 11-13,000 feet in Nepal being on my feet 4-6 hours per day.

Given all the information above, what might you suggest I do to calm any doubts I have about the impact of a trip like this on my heart or valves or ???  

Also, I don't understand how it is that the EKG was trumped by the echocardiogram.

Thank you.

[kenkeith]

An EKG is not very reliable source to identify the structual anatomy and physical condition of the heart (better adapted for rhythm diagnosis)..  The test records electrical impulses as it passes from one lead to another and the measurement of mvolts and msecs could mean scared tissue form a previous heart attack, if the impulse takes more time to pass it could mean an enlarged heart, etc.

An echo uses ultra sound and provides an image of the heart.  An inferior infarct is damaged heart cells.  An echo views the beating heart and if there is damaged heart tissues the heart wall will impair heart wall movement...medically termed hypokinesis for some impairment and akinesis for necrotic heart cells.

Some valve insufficiency is oftened considered medically insignificant and does not advance nor present any problems.
Hope this helps.  Take care.