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Heart Diagnosis

I just had a Nuclear Stress Test. The results showed everything normal except: LV is normal, normal thickness. Overall left ventricular systolic function is normal with an EF between 60-65%. The diastolic filling pattern indicates impaired relaxation. Mitral Valve - mild mitral regurgitation. Aortic Valve is trileafiat-mild aortic valve sclerosis without stenosis. Moderate-to severe aortic regurgitation present-no evidence of aortic stenosis.
The perfusion images show medium sized area of moderate to severe intensity mid and basal inferior wall predominately fixed defect with minimal reversibility. No significant left ventricular myocardial ischemia at the work load achieved. Overall left vent. systolic function is low normal with calculated ejection fraction of 47%.
I have been reading up on this. Some of the reports say that this is the beginning of early heart failure. Could you please give me your opinion. Overall, I am very healthy, very active for 65. Most people guess me in my early 50's. This is really bothering me, because I have always been so healthy. Heart disease does run in my family. Just like another opinion if you will. Thanks GL
Best Answer
976897 tn?1379167602
This report really needs to be put alongside other test results to establish a complete picture. An ultrasound (echo scan) would be invaluable because it would be nice to know the pressure in your left Ventricle and Atrium. You Aortic valve has moderate to severe regurgitation, in other words, it leaks. As your left ventricle is forcing blood out into your body, through your aortic valve, the leak is letting blood flow back in, and this will cause back pressure.
Your EF of 47% is just below normal and not a real problem as yet. However, I would pressure your Doctor to get an Ultrasound Scan done.
Perhaps someone else can comment, but your left ventricle relaxation is impaired. So it's not relaxing as it normally should, in one area. Is it possible you've had a heart attack in the past and formed scar tissue?

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976897 tn?1379167602
Sorry just to add, I forgot about your aortic valve. It is important that your cardiologist actually gets the severity of this problem accurate. Again Ultrasound will do this and if they are unable to get a good image, then you can have a TEEE. This involves swallowing a small device so they can get it closer to the heart. It sounds much worse than it is. If your aortic valve is leaking really badly, this will cause your EF to be affected and it will need to be repaired.
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976897 tn?1379167602
Thank you for your reply.
First and foremost, what you need are some thorough tests. As I suggested before, an Ultrasound is paramount. I also think it would be wise for your Cardiologist to do an Angiogram and establish the condition of your Coronary Arteries. It may be that the area which isn't relaxing correctly can be reversed to some extent, it depends on how blocked the artery is and how deep the muscle has been affected through the wall. Although the report says "minimal reversibility", nothing is in concrete until they look inside the artery. I think an Angiogram would be very wise to ensure there are no other blockages forming, it's important to keep on top of this. Don't go getting scared of heart failure etc, you are a long way off that yet. If your Cardiologist runs the appropriate tests and checks/treats your arteries as necessary, your prognosis is very good.
May I ask you something else, I am wondering how you got artery disease. I know you have a family history, but it isn't always genetic. For example, My parents smoked, so did I and my two brothers never have. My parents had CAD, I have CAD but my two brothers do not. So, bad habits can be causes, making it look like a family history. Stress is a definite contributor to my problem, both heart attacks have occurred after severe stressful times in my life. I was just wondering if you are often stressed.
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Avatar universal
Yes, I evidentally had a heart attack - when, I am not sure. I use to have Chronic Reflux problems and my symptoms felt like Cardiac Chest Pain, but, the doctors assured me it was from my reflux problems, I usually never had regular heartburn - usually severe pains in my chest. I had reflux surgery 12 years ago. But, I do remember one incident that was so painfull, my husband & I discussed me going to the hospital. I had no idea I had any heart problems & thought the pain I felt was actually from the reflux problem. So, I decided to not go to the hospital. Now that I look back, I feel this is probably when I had the heart attack and didn't know it due to the fact these type of pains was pretty normal with the reflux problem prior to my having surgery.
This news was a bit of a shock to me this week, as I explained I am a very active person & do not take any med's. My cholesterol is great, normal blood pressure and basically no health problems other than the heart.
Is their anything that I can do to keep my heart situation from getting worse or help the impaired ventricle relaxation. I already knew about the aortic valve problem and its insufficiency. Right now my opening around the aortic valve is 1.8%. I know eventually if it decreases in size & the valve gets stiffer, I will have to have surgery.

The thing that concerned me was the impaired relaxation. How does this affect me as I age? Can I still live a fairly normal life even with this impaired relaxation problem?  How quickly does these problems progress? Thanks for your help - GL
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