Echocardiogram for faintness/presyncope

[brd773]

I recently began to experience faintness - moreso during exertion and workouts. I've been working out for nearly 3 years so this is new to me. Here were the results.

30something years old male
bmi 22.4
never smoked, never drank, no drugs.
Lift free weights 5 days a week for 1 hour. Bike or jog 3 days a week for 1.5 hours - moderate pace.


La Volume    42ml
EF%            65.6
Ao root diam 3.11cm
IVSd            1.14cm             ***noted as above range 1.10
LVPWd        .763cm
LV FS          36%
LA dim         3.5cm
LVIDd           5.4cm
LVIDs           3.43cm

Aov VMax    149cm/s
LVOT Vmax  125cm/s         ***noted as above range 100cm
Ao max PG   8.83mmHg

MV pk e-vel   90.4 cm/s
MV ps A vel  53.3cm/s

Mv dcel time 230ms
MV E/A       1.7
E/E' Medial  8
P Vein S/D Ratio 1.5
IVRT            85ms  

TR pk vel 226mc/s
RVSP     25mmHg
Tr pk grad  1.21mmHg

The descriptive results state:

There is trace tricuspid regurgitation

There is mild mitral regurgitation.

Are my numerical stats within range for my stated demographic?
  
Also, what is the significance and origin of the two regurgitations?

Should I consider anything when working out in the future?

Thank you

ps - I had an ekg on the initial office visit and he said it looked normal.

[Mom2four85]

most dr's do not even look at ANS issues with syncop/pre-syncope; it's a knee jerk reaction to first dx anxiety - which is easier to deal with than take the time to find what's going on.

I've fainted and had arrhythmia's since I was 9, I was told it was for attention growing up, then as an adult it was stress, anxiety or a million other things they tried to pin it on until I almost died from my heart stopping at age 42.

Dehydration and electrolyte imbalances can cause problems; so if they've checked those and you make sure you stay hydrated it may be helpful to find a doctor who will do some further testing to see if you have ANS dysfunction.  Here's a link with info and dr's http://www.medhelp.org/health_pages/Neurological-Disorders/Autonomic-Dysfunction--Dysautonomia-Index-Page/show/857?cid=196  also the National Dysautonomia Research Foundation NDRF.org has a list of dr's as well as the DI Network dinetwork.org

It may be worth checking out and could simply be the imbalances causing this but be cautious when you're feeling faint or lightheaded; there are times I faint and I have no clue which could be dangerous; luckily the only time I fully fainted driving there was no one on the sidewalk I ran up on.

[brd773]

My Blood pressure ranges from about 90/58 to 115/70. Usually around 110/60.

No they didn't do a tilt table test. I made the mistake of telling them I had generalized anxiety disorder and they attribute it to that. Which is not the case since I've had that for decades and this is a new phenomenon. I did do a halter monitor for a day - and I pushed my limits of exercise during that - got up to 175 bpm in 95 degree heat. He said it was normal.

I've always had postural hypo-tension which they say has to do with personal physiology and/or water consumption. They took my blood pressure manually before and after laying down to standing position and it dropped a bit over 20 points. But the recent faintness occurred around exertion and then remained afterword when I was doing nothing. And more recently, I'm feel faint while doing nothing - like watching tv a spell will come from nowhere. I'm not sure, I think maybe my ans is sensitive to electrolyte imbalances. That's all I can think of at this point.

Thanks

[Mom2four85]

did they also do a tilt table test for your faintness/presyncope? how long does it last and do you have any other symptoms when you're having these espisodes, before or after them? do you also have blood pressure issues? have they done an exercise stress test?

it could be a mixed signal in the ANS (autonomic nervous system) depending on what's going on since your echo seems to be pretty normal, do you notice these episodes or symptoms more if you move up or down or stand up/bend down?

make sure you're hydrated during your workout also; a drop in your bp during a workout could cause you to have presyncope or faintness and dehydration does sometimes cause this

[brd773]

Thanks, the LVOT Vmax  seems to be right - it's the maximum velocity for the left ventricle output tract with units of cm/s. I just cannot find any ranges or descriptions for it outside scientific papers.

[kenkeith]

Q: IVSd = 1.14cm             ***noted as above range 1.10

>>IVS is the heart wall that separates the left and right heart ventricles and (d) is the parameter during diastolic (filling phase).  If seriously enlarged it could compromise the filling capacity as the wall would more rigid than normal.  Also, a rigid wall could effect the ejection fraction (normal is 50 to 70%)...amount of blood pumped into circulation with each heartbeat.

Q: LVOT Vmax  125cm/s         ***noted as above range 100cm

>>There may be an error.  LVOT is the left ventricle output tract and accepted range is (2.0 - 2.2 cm).  

Q: There is trace tricuspid regurgitation

>>considered medically insignificance and almost never progresses not advance.  Indicates some backflow of blood into the upper chambers when the heart pumps...the leaflets do not tightly close over the valve opening (orifice).

Q: There is mild mitral regurgitation

>>different adjective than trace but the same insignificance as trace.

Based on your posted report there doesn't appear to be medical concerns that would prohibit workouts, but until you have a dx of the faintness it would be wise to have your doctor's opinion.

Thanks for the question and if you have any further questions or comments you are welcome to respond.  Take care,

Ken