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Echocardiogram showed diluted left atrial. Have high BP and anxiety. Is an enlarged left atrial reversible?

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I've just had some tests done on my heart. The first been a exercise ECG which was negative. I also had a echocardiogram done which was normal except in the conclusion of the report it said severe diluted left atrial . All other chambers normal. EF 77%.
The cardioligist isn't concerned about this but iam. I suffer from high blood pressure but medication is controlling that. I also suffer from severe anxiety which is not medicated as I can't handle the side effects of medication.
Is an enlarged left atrial reversible ? And also can I keep exercising as I do very demanding exercise with a trainer .
Also I had a angiogram in 2009 which was normal.
Posted Tue, 18 Sep 2012 in Hypertension and Heart Disease
Answered by Dr. Anil Grover 4 hours later
Hi there,
Thanks for writing in.
I am a qualified and certified cardiologist. I read your question with diligence.
I think you meant dilated left atrium while describing left atrium on echo not diluted.
Yes, your cardiologist ought not to underestimate severe hypertension. By the way waht drugs you have been prescribed we can go through the list. To answer your later question yes if your blood pressure remains controlled with drugs there are chances left atrium enlargement may not be there any more. Well, in any case if your TMT is normal and you have a wonderful function of heart with echo showing 77% EF you ought not to worry about left atrium
Yes anxiety needs to be treated if you feel so. What are your thoughts about taking professional help for controlling anxiety. If I am not wrong I am tackling question with pseudonym/email id dougy2248 third time. Do you feel like consulting others in WWW.WWWW.WW or in person from your hospital,
Good Luck. Looking forward to hear from you
Dr Anil Grover
MBBS, MD (Medicine) DM(Cardiology)
Cardiologist and Internist
http:/ WWW.WWWW.WW
Above answer was peer-reviewed by
Follow-up: Echocardiogram showed diluted left atrial. Have high BP and anxiety. Is an enlarged left atrial reversible? 4 hours later
Hi Doctor,
The actual results were with 2D echo the area of the LA was 26.7cm2.
Would you call this severe?
I thought that would be moderate.
Answered by Dr. Anil Grover 47 minutes later

Thanks for your getting back. As you had asked a technical question I wanted to be sure in what I am writing I did consult books on the subject.

Standard echocardiography text books on the subject of LA write that body surface area should also be taken into consideration. I know you are somewhat overweight and has larger body surface area therefore, it is my considered opinion that with 2 D echo (depends on one view was used or other was also used and we do not know) it is at the best moderate enlargement of LA area so you have a point there. I have taken following text from what a reputed echocardiographer writes about LA. I quote what XXXXXXX J. ARTEL, MD, FACC, from Florida writes that because of at times because of asymmetric enlargement linear measurements can be fallacious and it is volume which out to be derived from area taken from views from tow sides and he like most support that Body Surface are which depend upon height and weight ought to play the role in calculation: Quote begins
"The machines automatically calculate the volume, but the basic formula is: A1 x A2 x 0.85/L x BSA, where A1 is area in 4 chamber view, A2 is the 2-chamber area, and L is the length from the far end of the LA to a line drawn across the mitral annulus in each view, whichever is shorter. BSA is the patient's body surface area (so the patient's height and weight need to be recorded at the time of the echo). A Simpson's area can be used as well, but I think this method is easier to accomplish. The result's units are cc/sq. meter. 22 + or - 6 is normal, >=40 is severely dilated" end of quote.

If you have any further question I will be most happy to answer though this time you will have to wait few hours for answers as I am going out. Good Luck.
Cheers to you too.
With Best Wishes.

Dr Anil Grover
Above answer was peer-reviewed by
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