Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
196 Doctors are Online

Obese, experienced dyspnea with exercise. Suspected of diastolic dysfunction, ECG showed mild enlargement of atrium and valve. Advise?

User rating for this question
Very Good
Answered by

General & Family Physician
Practicing since : 2009
Answered : 3089 Questions
Question
I am a 55 yr old slightly obese female who in the past few months has experienced severe dyspnea with exercise even just walking a short distance. My pulmonologist has a suspicion I have diastolic dysfunction. I just had an echocardiogram at it indicated a mild enlargement of the left atrium as well as mild mitral valve and tricuspid valve regurgitation. If all of this is mild, why am I experiencing such severe dyspnea? Atrium size 4.38cm
Posted Sat, 21 Sep 2013 in Hypertension and Heart Disease
 
 
Answered by Dr. Luchuo Engelbert Bain 45 minutes later
Brief Answer:
Cardiologic review, control cardiac ultrasound

Detailed Answer:
Hi and thanks for the query,

its interesting that you did an echocardiogram already. It is clear from what you describe that there is a lesion at the level of the heart. However, with these mild dysfunctions, I would suggestion the causes of the dyspnoea should also be searched out elsewhere. I am sure your pulmonologist must have asked to exclude any history of asthma, and done some spirometric (breathing and volumes analysis). If not, it should be done. Overweight on its own in some people could cause dyspnoea. Losing weight could also be of help.

I would however love to consider measures from a clinical point of view. Your cardiologist could be of utmost help. The cardiac ultrasound is operator dependent. It might be necessary to get it done again or by another specialist. It is not unusual also to have situations where the clinical scenario does not actually match, in terms of intensity, what is presented by the results.

I suggest you get a complete review by by a cardiologist, and a control cardiac ultrasound. A history of heart disease or notion if sudden death in the family tree could also be of importance to your doctor.

Thanks and kind regards.

Bain LE, MD
Above answer was peer-reviewed by
 
Follow-up: Obese, experienced dyspnea with exercise. Suspected of diastolic dysfunction, ECG showed mild enlargement of atrium and valve. Advise? 9 hours later
I forgot to tell you that I was diagnosed the same time as the dsypnea began with pneumonitis from CT results. This was July. Also lab work was performed and at that time my BNP was 81. The BNP was repeated a week ago and it increased to 217. Could you explain what a control cardiac ultrasound is.
 
 
Answered by Dr. Luchuo Engelbert Bain 3 hours later
Brief Answer:
You need to consult a cardiologist.

Detailed Answer:
Hi and thanks for the updates,

A control ultrasound means you do an echography/ utrasound of the heart all over again. This is to be very sure of what s going on. As I mentioned, it is an exam that is very operator dependent.

The raised BNP is actually very suggestive a dysfunction at the level of the heart, and shall certainly deserve a review by a cardiologist.

You need to see a cardiologist for a review in my humble opinion. Thanks and kind regards.

Bain LE, MD
Above answer was peer-reviewed by
 
Follow-up: Obese, experienced dyspnea with exercise. Suspected of diastolic dysfunction, ECG showed mild enlargement of atrium and valve. Advise? 8 hours later
Thank you for your thoughtful opinion on this. I will seek a cardiology consult. I have an underlying overall feeling that something is very wrong. I am a nurse who is on medical leave at this moment because of this problem. But when I have a patient who states the same thing as me, they are usually right. You have to trust your basic instincts and mine is saying something is wrong. I did have a maternal grandfather die suddenly at 53 and my mother has a cardiac history but I related it to her smoking and severe COPD. I am trying to look at this professionally, but it is too personal. I know that it is difficult for you to say specifically what you really think. Lawsuits are too common. Everyone in the medical profession has to be very careful of anything said. My sense of your opinion is this is serious and I appreciate your help.
 
 
Answered by Dr. Luchuo Engelbert Bain 2 hours later
Brief Answer:
I do appreciate you too

Detailed Answer:
I will be honored and glad to chip in a thought if you deem it necessary anytime.

Thanks again and kind regards,

Bain LE, MD.
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Lab Tests

The user accepted the expert's answer

Ask a Cardiologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor