Heart Rhythm

[jeanette1952]

Sorry this is so long. I am a 62 yr. old female.

I had written before that I went into A Fib on 5/31/14 and converted back in hospital after 10 hours.  Had echocardiogram done while I was in A Fib.   Results:

    - Left and right Atrial size noral
    - Right  ventricular size normal.
    - Aortic valve - No degree of aortic stenosis  
       present.
    -  Mild mitral annular calcification.
    - Mild tricuspid regurgitation.
    -  Mild pulmonary hypertension.
   - Left ventricle: LV ejection fraction estimated
      at >60% (hyperdynamic).
    - Ventricular LVPW and IVS wall thickness
       normal.
    - Evidence of Sigmoid Septum.
    -  No LVOT obstruction.
    -  LV fractional change is normal.
    - Grade 2/ pseudonormal diastolic
       dysfunction (increased left atrial pressure
       and increased left end diastolic filling
       pressure.   Wall Scoring: All segments are
       normal
     - LV systolic function: EF-A4C View: 56.6 %

Heart Cath Results: (not in A Fib when cath was done).
        - No aortic stenosis  visualized.
         - No mitral valve insufficiency  noted.
         -  Global left ventricular systolic function
            was normal.
         - Left main coronary artery showed no
          disease.
        -  Proximal LAD showed 40% stenosis.
        -  Proxmal  1st diagonal branch revealed  
            50% stenosis.
         -  Right coronary artery showed no
             disease.
         -   Circumflex artery showed mild luminal
              irregularities but no disease.
          -   Global left ventricular systolic function
              was normal.
          -  Left ventricular ejection  fraction was
              estimated at 60-65%

What does all this mean? I can figure out some of it but certainly not all of it.  Thanks for any input.  You guys are great on here.  

[jeanette1952]

Thanks to all who responded to my inquiry.  Much valued and appreciated.

[pvctom]

hi,

i was looking at your post and your echo and heart cath looked good to me, I am not a medical person, but i noticed your Left Ventricular Ejection Fraction Ratio was 60-65%. I was informed by my cardiologist that that was a good percentage. hope this helps.

[is_something_wrong]

It seems like echo results in the United States are far more detailed than in my country. Everything which is found is listed, and what's important is to determine what is abnormal and what is a natural consequence of time (our hearts change throughout life). What's normal for a 62 y/o might be abnormal for a 20 y/o and vice versa.

Mild calcification and regurgitation is fairly normal and not a concern. What sounds slightly concerning is the grade 2 diastolic dysfunction. It is graded from 1 to 4, where in grade 2 the results (early filling : late filling) looks normalized but a higher atrial pressure reveals the abnormality.

The left ventricle will always to some degree stiffen as we grow older, but hypertension will accelerate this process. It is important that your blood pressure is kept under control.

To your heart cath results, you have some beginning narrowings of some of the arteries. Everyone does, and I'm not sure if 40-50% is significant or not. It should not cause any symptoms at least. Significant coronary artery disease is >70% narrowing of 1 or more coronary artery.

But overall, the results sound good to me.

[jeanette1952]

Thanks so much Elli126 for responding. I really appreciate it.

I guess the big question I have about the echo is the Grade 2 diastolic dysfunction.  Like I said I was in A Fib (my first and only bout  with it so far) when the echo was done.  I was already out of A Fib when they did the cath.
I tried to call the doctor (cardiologist) about the diastolic dysfunction, but could only speak with the nurse practitioner who really did not answer the question. She just said do what the doctor said to do.  But he never addressed the echo with me.  

[Elli126]

This is a good Echo. An EF of 55 or over is considered good. You have some slight irregularities but no disease. I'm no doctor so take this with a grain of salt but I work for a cardiologist and have looked at a ton of Echo reports and wish I had an EF as good as yours. A 50% stenosis at 62 isn't terrible according to my doc, we all get it with age, but really if you have questions or concerns with your results, ask your doc. Most don't mind answering questions and would rather have you ask than not.