ENLARGED LEFT AND RIGHT ATRIUM AND VENTRICLE

[boticurry]

Dear Doctor;
I was diagnosed with enlarged RA and RV about two years ago. I was subjected to a cardiac nuclear stress teat which did not reveal any problems. My cardiologist suspects a problem with my mitral valve. Just this week she put me through the same tests again which once again did not show any problems.

Can a nuclear stress test find a mitral valve problem? The test technician said that the nuclear test check for heart vessel congestion. I am concerned that I have had a nuclear test twice and they do not show any problems. I have a family history of heart disease. My dad dies young at 57. His cholesterol was normal.

Can you please suggest any other tests that can specifically check for this problem? My mum also has a mild heart murmur which was caused by rheumatic fever, but I did not have rheumatic fever as a child.

[kenkeith]

An ECG  can produce an abnormal result for many reasons not related to a heart issue.  For instances, an individual may have some anxiety and the EKG will be abnormal for a heart rate above 100 bpm.  Or an individual may be in good physical condition and the heart rate will normally be low (below 60) and that will cause an abnormal EKG.  Medication can cause an abnormality, electrolytic imbalance, etc.

ECG is helpful for a heart rhythm diagnosis, but unreliable for chamber sizes, structual anomalies, etc.

Hope this helps, take care.

Ken

[boticurry]

Ken;

Thank You for your assessment. I neglected to mention that I did have an ECG, where they noticed abnormalities, but all my EKGs always show some underlying problem, hence the doctor decided to perform more tests. As I mentioned the tests come back negative. I am wondering if I am just overly concerned. I must also add that I am physically active. I go to gym almost 5 times where I do aerobics - boot camps and I also cycle as well. This is where I noticed that I become breathless quickly. Perhaps I am just getting older. I am 48.

[kenkeith]

A stress test evaluates the perfusion of blood and provides evidence whether or not there is some occlusion. Helpful if there is chest pain and the location of any lesions, etc.

An echocardiogram is ultrasound that produces images on a monitor showing blood flow through the heart.  If there are valve insufficiency that will be clearly seen on the monitor.  Also, the dimensions of the heart wall are calculated as well as the heart chambers.  Strong heart contractions showing heart wall movement or lack thereof, the calculation of the amount of blood pumped with each heartbeat.  

You should have/had an echocardiogram.  I hope this provides some insight so you can further discuss options and solutions regarding your health.  If you have any further questions or comments you are welcome to respond.  Take care and I wish you well going forward.

Ken