breathing disorder

[vicky158]

I am dr.Waqar ,44 years old.
k/case of HTN
I had an attack of respiratory distress 4 days back
my Echo cardiogram shows the following results
NORMAL SIZED LV WITH NORMAL FUNCTION
NO WALL MOTION ABNORMALITIES
NON-STENOTIC MITRAL AND AORTIC VALVES
NO PS. NO EVIDENCE OF PERICARDIAL EFFUSION OR INTRACARDIAL MASS
NO MR
NOAR
NORMAL SIZE LV WITH NORMAL SYSTOLIC FUNCTION
GRADE 11-DIASTOLIC DYSFUNCTION
Plz comment

[kenkeith]

QUOTE: "NORMAL SIZE LV WITH NORMAL SYSTOLIC FUNCTION
GRADE 11-DIASTOLIC DYSFUNCTION". >>>>no other problems noted.

For some insight, diastolic dysfunction relates to the filling capicity of the left ventricle.  Filling capicity can be compromised by the LV's walls becoming  thicker crowding out filling space, and the thickened walls lose its elasticity and become more rigid.

In the early stages left ventricle systole may be pumping the same ejection fraction, but the cardiac output would be reduced.  Reduced volume output can be symptomatic with shortness of breath, chest pain, fatigue, etc.

The pathology of diastolic disorder:  "If the heart cannot readily fill with blood following contraction, one of two things must follow; either the cardiac output becomes diminished or compensation ensues to increase the ventricular diastolic pressure to higher levels. When the left ventricular diastolic pressure is elevated, venous pressure in the lungs must also become elevated to maintain forward flow. Increased pulmonary venous pressure results in alveolar edema causing the patient to be short of breath. Phrased differently, left ventricular stiffness makes it more difficult for blood to enter from the left atrium. As a result, pressure rises in the atrium and is transmitted back to the pulmonary venous system thereby increasing its hydrostatic pressure and thus promoting pulmonary edema".

Functional classification generally relies on the New York Heart Association Functional Classification. The classes (I-IV) are:

Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities.
Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.
Class III: marked limitation of any activity; the patient is comfortable only at rest.
Class IV: any physical activity brings on discomfort and symptoms occur at rest.

Do you have left ventricle wall and chamber dimensions?  That should be part of the echo report. I find the left ventricle size questionable as being normal and seems inconsistent with DD.

Hope this helps, and if you have any further questions, you are welcome to followup withother questions. Take care and thanks for sharing.