echo result question

[ready2help]

My mom (healthy and very fit, 76years, no surg hx, only med hx is well-managed IBS and dx CLL 2y ago, which has always been asymptomatic other than a monitored elevated WBC (in the 40's I think?), which was how it came to light). She went for routine echo - she sent me result. Her int med doc referred her for car consult - she's very nervous about it, very focused on it.

Since I am a lomg-time RN, she asks me many questions. Since she can't get in for weeks, I want to give her some info (and am curious myself, of course) but I don't work with any cardiologists in my practice. Would you tell me what your general impression is?

EF 55-60%
1.  Global LV systolic function normal
2.  Moderate aortic regurg; mild calcification
3.  Mild-mod tricuspid regurg
4.  Doppler study of the mitral valve inlow pattern suggests abn LV relaxation (mild LV diastolic dysfunction.

Those are the impressions. I would like to know what is it that is indicating the need for further consult? What is the concern here? I assume some of this is normal aging? Or not?

Thanks in advance for your help.

[ready2help]

In case there might be a further comment, her pul art systolic pressure is estimated at 38.1; no pul valve regurg.

Thanks so much for your comments. She has never had hypertension nor elevated lipids nor smokes, and she is quite a bit of a "health nut": eating very heart healthy and exercising daily (funny thing - she did this as long as I can remember, even before it was "popular" to do so - her mom and grandmother did it as well. PS The women in my family have all lived into their 90's!)

Thanks so much, you are a tremendous help. My folks live on "the other coast" and I don't have the opportunity to hear what the docs say to my parents at their visits nor the ability to ask questions. Mom was particularly concerned about this one since she never has anything but a normal exam (you can imagine how upset she was about the CLL diagnosis!) and it will be weeks before she can get in to the CAR.

Be well.

[Darcy Green Conaway, MD]

The heart appears to be contracting normally. The aortic valve is leaking back (that is classified as "mild", "moderate" or "severe" and hers is in the moderate category which means it should be monitored). The mitral inflow pattern is one of the parameters we use to evaluate diastolic function of the heart (how well it relaxes). She appears to have mild diastolic dysfunction-- some feel this is a normal variant for elderly people, but the most common reason is hypertension that has caused a thickened heart muscle. The tricuspid valve is a little leaky about 90% of the population I would worry less about that. It would be good to know what her pulmonary pressures were. She does need aggressive risk factor modification since aortic valve calcification is also often a marker of underlying atherosclerosis. Hope this was helpful