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diastolic dysfunction

i am a 72yr old female, weigh 190, nver smoked or drank, have been on blood pressure meds for approx 2yr.  just was in hosp with spiking blood pressure, some fluid around heart luncgs and some shorntness of breath.  An echocardiogram was done with a diagnosis of borderline concentric left ventricular hypertrophy---diastolic dysfuntion---ejection fraction--65%--have an apt to see cardiologist this week.

My question----can this be reversed and how?  I am on blood pressure meds and diruretics at this time.  Have also started on cardiac diet and have dropped 6lbs since returning home from hosp.

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367994 tn?1304953593
*Could the hypokinesis be caused by malfunction not blockage?  Which meds reverse the hypokinesia?

>>>>>-weakness of the heart muscle, blockage in the coronary arteries , abnormal  electrical conduction in the  heart, certain valve problems--basically there are many causes.  

If the underlying cause can be efectively treated, that could revitalize the specialized heart cells to again normally stretch and contract heart tissue.

QUOTE: Prior to having the stent, were you having disabling symptoms "fluctuating" to being very disabling such as walking a few steps sweating profusely (not hot weather), chest pains, dizziness, whooziness, lightheadedness?

>>>>My first symptoms were the result of heart failure.  I had had a silent heart attack due to ischemia (occluded vessels) and this caused fluids to leak into my lungs.  As a consequence I had shortness of breath, lying down would cause hyperventilating, faster than normal heart rate at rest (115 bpm).  I believe I triggered CHF by working in an enclosed dusty environment without a mask.  When went to ER I thought the problem was just the lungs and was shocked to hear I had a heart problem.

The symptoms you are describing are warning signs of a possible heart attack if cardiovascular related. There can be variations when the symptoms occur, and probably related to stress, just having a large meal, cold weather or hot weather, amount of exertion, medication or lack thereof, drinking alcohol,  etc.
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Avatar universal
Thanks for the reply, just on those with ******

>>>>If the hypokinesis (impaired heart wall movement) is the result of ischemia
(lack of blood flow), the defect can be successfully treated with restoration of adequate blood flow to the deficit area....often with ischemic hypokinesis the heart cells are stunned or in hibernation. Your condition may be helped with medication that dilates the vessels enough to provide sufficient blood flow. About 6 years ago I had hypokenisis of a heart wall and lower than normal EF, a stent to 98% RCA and medication
returned my heart to normal size, no hypokinesis and normal EF. I have/had a 72% blocked circumflex and take a nitrate prior to a physical workout
.
******Could the hypokinesis be caused by malfunction not blockage?  Which meds reverse the hypokinesia?

Prior to having the stent, were you having disabling symptoms "fluctuating" to being very disabling such as walking a few steps sweating profusely (not hot weather), chest pains, dizziness, whooziness, lightheadedness?  This fluctuates, and I believe if there was a blockage, I would have this all the time, wouldn't I?

The agina can be very severe, and fluctuate, some days all days, other days none!!  Perplexing ...






Many thanks,
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367994 tn?1304953593
QUOTE: " Ken, I also have left ventricular dysfunction and hypokinesia of the septum, is it ikely that this may be caused by a blockage?"

>>>>If the hypokinesis (impaired heart wall movement) is the result of ischemia (lack of blood flow), the defect can be successfully treated with restoration of adequate blood flow to the deficit area....often with ischemic hypokinesis the heart cells are stunned or in hibernation. Your condition may be helped with medication that dilates the vessels enough to provide sufficient blood flow. About 6 years ago I had hypokenisis of a heart wall and lower than normal EF, a stent to 98% RCA and medication returned my heart to normal size, no hypokinesis and normal EF. I have/had a 72% blocked circumflex and take a nitrate prior to a physical workout.

QUOTE: "Does this seem typical of diastolic heart failure (mild, normal EF, BNP is slightly over normal limit) or does it seem to be more likely to be a blockage?"

>>>>Any reduction of the cardiac output can cause the symptoms you describe.  Diastolic impairment relates to a filling problem (stiff heart walls that don't relax to adequatedly fill).  As a result less blood pumped with each stroke....usually the EF is preserved until the condition becomes very serious.

An echo would/should provide the distinquishing factors to properly analyze...heart walls enlarged and thick, chamber space compromised, etc. would indicate DD.  Impaired heart wall movement would be visable as the images are in real time as the heart beats.

Hope this helps, and if you have any further questions you should keep questions and answers on one thread to prevent confusion.  Thanks for the question and take care.
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Avatar universal
Ken, I also have left ventricular dysfunction and hypokinesia of the septum, is it likely that this may be caused by a blockage?

If I do the angio and they put a stent, can it reverse the LVF and hypokinesia of the septum?

Sorry, I am trying to make a decision as if I should have the angio or not.  I am terrified of what I read about the contrast dye, and my own past experience with that.

You may have read my previous post today.

Any slight physical exertion, even walking a few steps outside, slowly, but very SLOWLY, makes me dizzy, light headed, whoozy, sweaty with a some angina in the lower jaw.

Does this seem typical of diastolic heart failure (mild, normal EF, BNP is slightly over normal limit) or does it seem to be more likely to be a blockage?

Thanks.



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367994 tn?1304953593
For some insight, concentric LV hypertrophy means that the muscle of the left sided pumping chamber of the heart has increased in size and thickness. Often the disorder occurs because of either high blood pressure or any obstruction to the outflow of blood from the left heart.
Commonest example of obstruction to the out flow of blood is narrowing of the valve opening (aortic valve). Your doctor is the best source to determine the underlying cause and can tell you as to the real reason of this LV hypertrophy.  Remedial measures can only be taken once you know the cause of LV hypertrophy.

Generally, chronic pressure overload (high resistance due to narrow vessels....hypertension) results in wall thickness.  The thickness of the heart does relax and becomes stiff  to the extent that permits in adequate filling which can impair filling and lead to diastolic dysfunction.  High blood pressure medication can prevent any further pathology and may help reduce the heart's size.  You have marginal heart issues as indicated by your report, and medication can at least prevent any further non-compliance.

Treatment for pericardial effusion (fluid around heart) will depend on the cause of the problem. Often the condition will resolve itself, sometimes the fluid can be drained with a needle, and medications may be an option as well.  

Hope this helps give you a perspective.  If you have any follow-up questions you are welcome to post.  Thanks  for sharing.
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