Am I at risk for heart disease

[bl19811]

HI I am a 30 year old male. I smoke about 1/2 pack a day and for the last two months I have been short of breath after exercising. I can just walk about half a mile and afterward I am doing everything to catch my breath. I have had chest x rays and ct scans done and they say everything is fine. But I also have chest pains afterwards too. I recently had a EKG done and that was fine, so my doctor had a echo test done. I am worried about the findings I had done. I had the test done on friday the 8/12, but I am waiting to here from him. Here are what they found out:  

Final Conclusion
Normal LV size and systolic function with estimated ejection fraction of 55%.
Normal left ventricular diastolic filling pattern for age.
The left atrium is normal in size.
The right ventricle is normal in size and function.
Normal estimated PA pressures on this study. Right ventricular systolic pressure estimated at 14 mmHg + RAP.
Dilated IVC suggestive of increased right atrial pressures.
Mild mitral regurgitation.
Mild tricuspid regurgitation.

FINDINGS
Left Ventricle Normal left ventricular size, wall thickness, and systolic function with no obvious regional wall motion
abnormalities. The ejection fraction is visually estimated at 55%.
LV Diastology Normal left ventricular diastolic filling pattern for age.
Right Ventricle The right ventricle is normal in size and function.
Left Atrium The left atrium is normal in size.
Right Atrium The right atrium is normal in size.
IVC Dilated IVC suggestive of increased right atrial pressures.
Aortic Valve Structurally normal trileaflet aortic valve. No aortic valve stenosis or regurgitation. No aortic
regurgitation.
Mitral Valve Structurally normal mitral valve without significant stenosis or prolapse. Mild (posteriorily directed)
mitral regurgitation.
Tricuspid Valve Structurally normal tricuspid valve without significant stenosis. Mild tricuspid regurgitation. Normal
estimated PA pressures on this study. Right ventricular systolic pressure estimated at 14 mmHg + RAP.
Pulmonic Valve Structurally normal pulmonic valve without significant stenosis. There is no significant pulmonic
regurgitation.
Aorta The sinuses of Valsalva, sinotubular junction, and ascending aorta appear normal.
Pericardium Normal pericardium without effusion.
MEASUREMENTS (Male / Female) Normal Values
2D MEASUREMENTS AND LV FUNCTION
IVS Diastolic Thickness 0.772 cm < 1.1 cm
LV Diastolic Diameter PLAX 5.1 cm 4.2 - 5.9 / 3.9 - 5.3 cm
LVPW Diastolic Thickness 0.912 cm  30%
LV Ejection Fraction MOD BP 62.5 % >= 55 %
LA Volume Index 10.1 ml/m² 16 - 28 ml/m²

AORTIC VALVE
Aortic Root Diameter 3.22 cm
AV Peak Velocity 1.17 m/sec < 2.0 m/sec
AV Peak Gradient 5.47 mmHg
AV Mean Gradient 3.03 mmHg
AV Velocity Time Integral 26.6 cm
LVOT Peak Velocity 1.02 m/sec
LVOT Velocity Time Integral 21.9 cm
AV Area Cont Eq vti 3.17 cm²
AV Area Cont Eq pk 3.35 cm²
AV Dimensionless Index 0.822

TRICUSPID VALVE AND ESTIMATED PRESSURES
TR Peak Velocity 1.9 m/sec
TR Peak Gradient 14.4 mmHg

I am wondering do I have anything to worry about or is every thing look fine.
I am just trying to figure out why I am having these problems.

[curmudgen]

FYI - http://www.buzzle.com/articles/elevated-alkaline-phosphatase-causes.html

[bl19811]

not yet i go tomorrow to see my doctor and i am going to see if i can be tested for it

[ed34]

Have you tried avoiding gluten to see if the problem improves?

[bl19811]

The only exercise i do is walking about a mile twice a week. I use to be in the army but that was ten years ago. I am also worried about ALK PHOSPHATASE which was 134, which is high, i know this will be high if you have a infection but I have not had any signs of being sick in the last 6 months. That is why i was wondering if i could have celiac disease because my mom had the same problems and she has that now. Should I be worried

[curmudgen]

I couldn't help but respond...yes you are at risk for heart disease....you smoke!  You are focused on your heart, which is normal,  but you continue to smoke...cutting down doesn't stop the damage you are doing.  end of lecture.

[ed34]

I don't think so. From what I see from your reports, the blood pressure (systolic) in your right ventricle is 14mm/HG and although estimated, this is absolutely fine. So, this means your heart is able to very easily push blood through your Pulmonary system, through your lungs. If there was a lung problem, then this pressure would be much higher and the right ventricle would begin to enlarge as it compensates for the extra work load. So, that side of things is fine.
The right atrium is of correct size and the tricuspid valve is normal too, so I'm really not sure where this is pointing. If the pressure was great in the ivc, then you would expect to see a valve or atrium sign showing this.  The report states "IVC Dilated IVC suggestive of increased right atrial pressures." but the word 'suggestive' doesn't mean necessarily so.
You have no arrhythmia problems either according to your EKG and so your heart looks fine.
Can I ask, have you just recently begun to exercise? or have you been doing this for years?

[bl19811]

My mom has celiac disease could I have that possibly I do get some bloating and abdominal pain and bad smelling gas once in awhile. Could this be part of my problem.

[bl19811]

no

[ed34]

have you had a chest infection recently? or a bad cough?

[bl19811]

I know smoking can be part of my problem. I have cut down dramatically in the last year a year ago i was smoking 1 1/2 packs a day. I also had some blood work done a couple of weeks ago here are the results:

WHITE BLOOD COUNT 13.3 4.5 - 11.0 thou/cu mm
RED BLOOD COUNT 5.27 4.30 - 5.90 mil/cu mm
HEMOGLOBIN 16.4 13.5 - 17.5 g/dL
HEMATOCRIT 48.3 37.0 - 53.0 %
MCV 92 80 - 100 fL
MCH 31.1 26.0 - 34.0 pg
MCHC 34.0 32.0 - 36.0 g/dL
RDW 12.3 11.5 - 15.5 %
PLATELET COUNT 319 140 - 440 thou/cu mm
MPV 7.9 6.5 - 11.0 fL
NEUTROPHILS 69.0 42.0 - 72.0 %
LYMPHOCYTES 23.0 20.0 - 44.0 %
MONOCYTES 6.3 < 11.1 %
EOSINOPHILS 1.0 < 7.1 %
BASOPHILS 0.7 < 3.0 %
ABSOLUTE NEUTROPHILS 9.2 1.7 - 7.0 thou/cu mm
ABSOLUTE LYMPHOCYTES 3.1 0.9 - 2.9 thou/cu mm
ABSOLUTE MONOCYTES 0.8 < 0.9 thou/cu mm
ABSOLUTE EOSINOPHILS 0.1 < 0.5 thou/cu mm
ABSOLUTE BASOPHILS 0.1 60 > 60 ml/min/1.73m2
GFR if not African American > 60 > 60 ml/min/1.73m2
ALBUMIN 5.0 3.5 - 5.0 g/dL
PROTEIN,TOTAL 8.3 6.0 - 8.0 g/dL
GLOBULIN 3.3 2.0 - 3.7 g/dL
A/G RATIO 1.5 1.0 - 2.0
BILIRUBIN,TOTAL 0.5 < 1.6 mg/dL
ALK PHOSPHATASE 134 34 - 104 IU/L
ALT (SGPT) 16 10 - 40 IU/L
AST (SGOT) 26 10 - 42 IU/L

I know my blood work has had some abnormal readings but i don't know what they mean i am just scared

[ed34]

Just to add. I know it's difficult, but if you stop the smoking then you will feel the benefits within a few hours because your oxygen levels will rise. Like I said, I know it isn't easy, I climbed the walls for months when I packed up. I remember believing for a long time that smoking wouldn't affect me but I gave up from feb 07 and in aug 07 I was told I needed a bypass. I went outside the hospital, scared stiff of the news, and lit a cigarette. It was nearly an hour before I could walk back inside due to the dizziness and nausea. I admitted to a Nurse what I had done and she took my blood pressure, it was 200/110 and took over 30 more minutes to drop. So from this I know cigarettes harm you. Please just try and stop smoking :)

[ed34]

Well in general it looks as though your ultrasound is good, apart from one aspect. Your Interior Vena Cava is dilated and this is the large vein which returns all used blood from the lower half of your body, back into the right atrium to be put back through the lungs to be oxygenated. The report doesn't give any more details regarding the vein, but it would be a good starting point. The tricuspid valve is normal which is a good sign.
Your EF at 55% is within normal parameters. Have they done a blood gas to check the oxygen/CO2 levels in your blood?
I wouldn't be surprised if they do a scan of the venous system in your lower body/legs. More blood tests will also give some good clues.