left ventricle dimensions

[tmac]

I am a 39 yr old woman that had an orange-size left atrial myxoma (sporadic)removed
3 years ago.  As a result, my mitral valve is stretched out and leaks(moderately). I have an echo yearly (more often initially) to keep an eye on this and watch for recurrance of the myxoma. Last week , my cardio called with the last echo results. He was a little concerned about the difference  in my LV sizes from a year ago. He said,
"its 4.9cm full and 3.5cm empty" vs( 4.3cm full and 2.6cm empty a year ago).
I have read all the archived letters about heart dimensions and have noticed that
no two answers are the same. I am at the top, bottom or  middle of the range depending on whose answer I read.  What is your opinion? Is there a margin of error within this test?  Is that a big difference in a years' time? My cardio is concerned enough about this to make me go back to an echo every 6 months.I thank you in advance for your opinion.
Sincerely, Terry

[CCF-M.D.-RCJ]

Terry,

Thanks for your question. I have provided echo normal values on a couple of occasion. I've tried to copy the results each time to provide consistency. The last posting was on 9/29/02.  Here are the dimensions pertinent to your question:

(2)"Full": LVIDd - Left Ventricular Internal Dimension (diastole); normal range 3.5 - 6 cm

(3)"Empty": LVIDs - Left Ventricular Internal Dimension (systole); normal range 2.1 - 4 cm.

I agree with your cardiologist's assessment to have evaluation every 6 months with echo and history/physical exam.  The ACC guidelines for offering surgery to asymptomatic patients with normal heart function is before the "empty" dimension becomes greater than 4.5 cm.  Your case is complicated by the history of previous surgery -- the threshold for repeat surgery will be higher.

Make sure that you are seen for a second opinion at a major cardiovascular institute, if that is not where you go currently, to ensure the best care.

Good luck.

[NgottMV]

Thank you for asking that question.  
I thought they were concerned with the size of the left atrium.
I now see that its the LVSDs empty phase of the left ventrical
My LVDDd was 5.2 and my LVSDs was 2.9  10/2000
Now my LVDDd is 5.4 and my LVSDs is 3.3 7/2002
My left atrial diameter went from 3.3 to 4.6.
So now I understand that the ACC guidelines for offering surgery to asymptomatic patients with normal heart function is before the "empty" dimension becomes greater than 4.5 cm. (LVSDs)