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Ventricular hypertrophy, restrictive diastolic filling, no valve abnormality - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3631 Questions
User :   hello
User :   I had a question about my recent echo results.
Doctor :   Hi,
User :   I will include the findings.
User :   Left ventricular ejection fraction is 50% Left ventricular cavity is mildly increased Mild concentric left ventricular hypertrophy RESTRICTIVE PATTERN OF LV DIASTOLIC FILLING that is the one that is really scaring me! everything I read is that is in advanced severe cases. why would I have this and not have any symptoms? is it reversable and what is the prognosis? I will also include the parameters MV Peak E- 1.09 m/s Lat e', MV ann- .19 m/s MV Peak A- 0.35 m/s Lat E/e' Ratio- 6 E/A Ratio 3.11 Sep e' MV ann-0.14 m/s Sep E/e' ratio 8 Avg e' 0.17 m/s Avg E/e' Ratio 7 Te'-TE 14.50 IVRT/TE 3.72 LV IVRT 54 msec MV DT- 363 msec
Doctor :   Please proceed
Doctor :   Ok,
User :   I am 23. have occasional shortness of breath they tell me its asthma and anxiety. im just really confused. i had an echo about 6 years ago and i never saw the results but the doctor was no concerned. what could this be?
Doctor :   Do you have High BP ?
User :   no my resting bp is usually around 120/62. although in my stress test it did go up a bit the doctor said it may mean i will have high bp in the future
Doctor :   Thats ok ,
User :   no
Doctor :   The above finding is not a serious one, and yes sometimes its reversible
Doctor :   Do you work out in GYM ?
User :   yes im about 270
User :   5 11
Doctor :   OK, Are you over weight ?
Doctor :   May I know your height ?
Doctor :   Ok, such changes in heart can be expected in people with high BP or obesity
User :   even the restrictive pattern? everything I have read says that is very serious
Doctor :   I would ask you to repeat the ECHO once again after a 3 month gap from the last one
Doctor :   and if the reports shows the same then you may have to consult a cardiologist for a detailed physical
User :   can you explain? valvular pathology?
Doctor :   If it was associated with any valvular pathology then it would have considered more serious
Doctor :   A Isolated ventricular hypertrophy alone with diastolic restriction and with no heart valve abnormalities in a young normal BP individual is rare and unexplainable
Doctor :   hence I would recommend and repeat ECHO in a different scan center after 3 months is good idea
User :   ok. so you dont think there is anything serious going on here?
User :   like restrictive cardiomyapthy? i have read alot about that
Doctor :   No , With one ECHO report I am not convinced that you have any serious heart problem
Doctor :   Have you got your EKG done ?
User :   yes i have had one dont know the results of it. i wore a holter monitor which showed "very rare PAC's"
Doctor :   Ok, but was there any comment on the amplitude of the QRS complex ?
User :   no. I overheard the doctor say, "he may have a little abnormal EKG" but i dont know what that mean
Doctor :   QRS complex corresponds to the electrical impulse associated with the ventricle
User :   echo showed trvivial tricuspid regurgitation and very mild mitral regurgitation
Doctor :   in cases where there is ventricular hypertrophy the amplitude of the QRS complex will be more(tall )
Doctor :   such mild regurgitation can be the cause of such changes in the ventricle but rare
User :   hello sorry I got cut off.
User :   I have read that restrictive patterns are the last stage in the diastolic dysfunction pattern, but I have read that Diastolic Dysfunction is unlikely if the left atrium is normal sized
Doctor :   yes, I agree with you
User :   ok, I'm sorry Im just very confused with all of this and its been over a month since I had my echo and my cardiologist wont get me an appointment sooner. would i be able to get to stage 5 on the stress test with severe diastolic dysfunction?
Doctor :   also ejection fraction being normal I too feel that the restrictive cardiomyopathy is one least expected anomaly
Doctor :   No, with diastolic dysfunction there would be arrhythmias and changes ion BP which makes you to face lot of symptoms
User :   ok thank you for being so helpfull! I also have read that sometimes young people have a higher E/A ratio because of the great suction in a young heart. its all just really scary for me escpecially since im a hypochondriac anyway.
User :   ok thank you!
Doctor :   need not worry
Doctor :   Get the scan repeated
Doctor :   I do not see any sign in you which correlates to the findings you have
Doctor :   hence reconfirm the findings first
User :   Thank you very much and have a great day!
Doctor :   You are welcome
Doctor :   Take care
User :   Wish you good health
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