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Is LVDD The Same As EDV?
Question: Dear Dr Iliri,
Sorry for the barrage of questions but I do have another one as it's troubling me.
Is LVDd the same thing as EDV? Is LVIDd the same thing? I ask because my recent echo reports, which I've sent to you have LVDd and LVDs and I was wondering if Simpson formula can be calculated from those numbers. If so, then it would be just 50, and then I would have an echo with three EF numbers: Teicholz 81.4, Cardio interpretation 60-65, and Simpson 50. I know I must simply trust my doctor but as a teacher of logic and programming, I become tied up in formulas and numbers.
Thank you so much.
XXXX
Sorry for the barrage of questions but I do have another one as it's troubling me.
Is LVDd the same thing as EDV? Is LVIDd the same thing? I ask because my recent echo reports, which I've sent to you have LVDd and LVDs and I was wondering if Simpson formula can be calculated from those numbers. If so, then it would be just 50, and then I would have an echo with three EF numbers: Teicholz 81.4, Cardio interpretation 60-65, and Simpson 50. I know I must simply trust my doctor but as a teacher of logic and programming, I become tied up in formulas and numbers.
Thank you so much.
XXXX
Brief Answer:
I would explain:
Detailed Answer:
Dear XXXX,
I would explain as follows:
LVDd and LVIDd are the same thing [Left Ventricular (Internal) Diameter in diastole) which may be found interchangeably between several echo reports.
Meanwhile EDV is End Diastolic Volume, so it is not the same thing as LVDd.
The first is a volume (which may be used to calculate LVEF by Simpsom method: EDV-ESV/EDV) and the second is a diameter utilized to calculate FS (fractional shortening: LVDd-LVSd/LVDd) and hence EF (by Teicholz).
In your uploaded echos 50-55% is not LVEF but FS (fractional shortening) and is supposed You EF to be much higher (up to a double FS value).
So, as you see, your LVEF is quite perfect, just compatible with your age, normal clinical status, perfect physical conditions.
If you have other uncertainties, you can discuss with me again!
Wishing you a nice week!
Regards,
Dr. Iliri
I would explain:
Detailed Answer:
Dear XXXX,
I would explain as follows:
LVDd and LVIDd are the same thing [Left Ventricular (Internal) Diameter in diastole) which may be found interchangeably between several echo reports.
Meanwhile EDV is End Diastolic Volume, so it is not the same thing as LVDd.
The first is a volume (which may be used to calculate LVEF by Simpsom method: EDV-ESV/EDV) and the second is a diameter utilized to calculate FS (fractional shortening: LVDd-LVSd/LVDd) and hence EF (by Teicholz).
In your uploaded echos 50-55% is not LVEF but FS (fractional shortening) and is supposed You EF to be much higher (up to a double FS value).
So, as you see, your LVEF is quite perfect, just compatible with your age, normal clinical status, perfect physical conditions.
If you have other uncertainties, you can discuss with me again!
Wishing you a nice week!
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much! So you are quite sure that EF is well above 50? I am still wondering why Teicholz 81 would actually be just about 60- arent measurements and visual reads normally closer in value?
I am relieved that there was no downturn in 5 months but still very much struggling with my water retention fears. With heart function still strong, would you assume BNP still normal and kidney function still strong? I was having those tested every week but cardio says I shouldnt need BNP test anymore at all and kidney test at discretion of my GP.
If only I could forget my fear of water brought on by my one unethical doctor, I think I would be ok. But he told me specifically that if I believed I was cured by ablation and meds withdrawn, I would start to retain water and quickly go into heart failure. It was almost sadistic- to make sure I would develop strong anxiety. I wish I had never seen that dr as his words keep haunting me. As soon as I can drink normally, and stop timing and measuring every drop of fluid, I will know I am truly over this horrible episode of my life.
Many many thanks again, Dr Iliri. I know I am getting stronger thanks to you.
Best to you,
XXXX
I am relieved that there was no downturn in 5 months but still very much struggling with my water retention fears. With heart function still strong, would you assume BNP still normal and kidney function still strong? I was having those tested every week but cardio says I shouldnt need BNP test anymore at all and kidney test at discretion of my GP.
If only I could forget my fear of water brought on by my one unethical doctor, I think I would be ok. But he told me specifically that if I believed I was cured by ablation and meds withdrawn, I would start to retain water and quickly go into heart failure. It was almost sadistic- to make sure I would develop strong anxiety. I wish I had never seen that dr as his words keep haunting me. As soon as I can drink normally, and stop timing and measuring every drop of fluid, I will know I am truly over this horrible episode of my life.
Many many thanks again, Dr Iliri. I know I am getting stronger thanks to you.
Best to you,
XXXX
Brief Answer:
No possibility of heart failure relapse seems to be coherent.
Detailed Answer:
Dear XXXX,
I am glad you are feeling better and relieved after the last cardiac ultrasound.
I am pretty sure your LVEF is quite normal (and much higher than 50%).
This is unequivocally confirmed by your repeated echos.
Regarding Teicholz, Simpson, etc. I would say they are complementary and dependent to a large degree on the observer accuracy, and suitability of the certain method to a certain clinical scenario. That's why a broad variability is not rarely encountered between different techniques.
My personal opinion is to not worry to much about those numbers, as the conclusion is you have a perfectly normal cardiac function and structure.
And to not consider any more that hypothetical heart failure relapse, as it seems quite incoherent logical option, facing your actual clinical conditions.
I wish you a pleasant weekend!
Best regards,
Dr. Iliri
No possibility of heart failure relapse seems to be coherent.
Detailed Answer:
Dear XXXX,
I am glad you are feeling better and relieved after the last cardiac ultrasound.
I am pretty sure your LVEF is quite normal (and much higher than 50%).
This is unequivocally confirmed by your repeated echos.
Regarding Teicholz, Simpson, etc. I would say they are complementary and dependent to a large degree on the observer accuracy, and suitability of the certain method to a certain clinical scenario. That's why a broad variability is not rarely encountered between different techniques.
My personal opinion is to not worry to much about those numbers, as the conclusion is you have a perfectly normal cardiac function and structure.
And to not consider any more that hypothetical heart failure relapse, as it seems quite incoherent logical option, facing your actual clinical conditions.
I wish you a pleasant weekend!
Best regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
Thank you, as usual, for your help and wisdom on these matters. I was feeling better but decided to ask a urologist here a question about my "favorite" topic, water retention. I shared my echo report and the dr has frightened me by saying I need frequent testing to make sure my "heart failure and valvular disease aren't progressing". He says my history of cardiomyopathy makes it much more likely I will experience heart failure. Here is a part of his 2nd answer to me. Though I asked for urologist, he sounds more like a cardiologist.
-------------------------------------------
"First of all the progression into the heart failure after 20-30 years is the worse scenario and it may happen in around 15-20% of cases. The risk of progression is increased with:
- Aging
- The previous positive history for cardiomyopathy and
- The presence of valvular regurgitation
- The presence of stress and depression
However, as I said above this may happen after to many years from now and you shouldn't worry to much for the moment. In order to relieve your concerns I would like to recommend cardiac examinations once a year (cardiac echo and biochemical blood work). As long as your heart and kidney will be normal there's no way to develop water retention and edema (you may have misunderstood the doctor)."
------------------------------------------------
Of course as I do experience stress, this has worried me very much. I was led to believe I had no increased risk of heart problems and that it was extremely unlikely that my trivial valvular regurgitation would progress. Now I am more worried.
What do you think of this opinion? If he is a urologist, it seems he has much experience in cardiac matters. Ah, even though embarassing,I should know to ask only you.
Hope you have had a good weekend
Many many thanks,
XXXX
Thank you, as usual, for your help and wisdom on these matters. I was feeling better but decided to ask a urologist here a question about my "favorite" topic, water retention. I shared my echo report and the dr has frightened me by saying I need frequent testing to make sure my "heart failure and valvular disease aren't progressing". He says my history of cardiomyopathy makes it much more likely I will experience heart failure. Here is a part of his 2nd answer to me. Though I asked for urologist, he sounds more like a cardiologist.
-------------------------------------------
"First of all the progression into the heart failure after 20-30 years is the worse scenario and it may happen in around 15-20% of cases. The risk of progression is increased with:
- Aging
- The previous positive history for cardiomyopathy and
- The presence of valvular regurgitation
- The presence of stress and depression
However, as I said above this may happen after to many years from now and you shouldn't worry to much for the moment. In order to relieve your concerns I would like to recommend cardiac examinations once a year (cardiac echo and biochemical blood work). As long as your heart and kidney will be normal there's no way to develop water retention and edema (you may have misunderstood the doctor)."
------------------------------------------------
Of course as I do experience stress, this has worried me very much. I was led to believe I had no increased risk of heart problems and that it was extremely unlikely that my trivial valvular regurgitation would progress. Now I am more worried.
What do you think of this opinion? If he is a urologist, it seems he has much experience in cardiac matters. Ah, even though embarassing,I should know to ask only you.
Hope you have had a good weekend
Many many thanks,
XXXX
Brief Answer:
My opinion:
Detailed Answer:
Hi XXXX,
Frankly speaking, I don't share the same opinion with the above prognostic quote, whichever it comes from: Cardiologist?!! Urologist?!!
But, I am not going to prejudge such an opinion, as it is correct in certain clinical backgrounds. Fortunately, not in yours.
I an quite sure in my statements, as I know better your clinical course, your previous cardiac disorder, your impressive improvements.
We have discussed quite a long periods regarding your health concerns and I hoped that you have clarified some topics of your concerns.
It would be useless to discuss issues already proven by the time to be impossible.
Nevertheless it is your right to check the medical opinion time after time, as long as some suspicions still remain in your mind.
I would like to assure you that I remain unwavering about my professional opinions offered to you.
Besides the need for some psychological support, probably some therapist's rounds, I find you completely normal regarding cardiac issues.
Best regards,
Dr. Iliri
My opinion:
Detailed Answer:
Hi XXXX,
Frankly speaking, I don't share the same opinion with the above prognostic quote, whichever it comes from: Cardiologist?!! Urologist?!!
But, I am not going to prejudge such an opinion, as it is correct in certain clinical backgrounds. Fortunately, not in yours.
I an quite sure in my statements, as I know better your clinical course, your previous cardiac disorder, your impressive improvements.
We have discussed quite a long periods regarding your health concerns and I hoped that you have clarified some topics of your concerns.
It would be useless to discuss issues already proven by the time to be impossible.
Nevertheless it is your right to check the medical opinion time after time, as long as some suspicions still remain in your mind.
I would like to assure you that I remain unwavering about my professional opinions offered to you.
Besides the need for some psychological support, probably some therapist's rounds, I find you completely normal regarding cardiac issues.
Best regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
I have checked and it was not urologist but cardiologist who answered my question and yet again flared my anxiety.
I know it must be tiresome to be faced with my same questions frequently. I will discontinue asking if you can please reassure me one last time that the water retention I fear so much is impossible and I am truly cured. I must stop monitoring my weight so closely and monitoring my fluids so much. I just want to believe I'm healthy and move on with my life.
Thank you so much for all your help. You have been so wonderful, wise, and kind.
Many many thanks,
XXXX
I have checked and it was not urologist but cardiologist who answered my question and yet again flared my anxiety.
I know it must be tiresome to be faced with my same questions frequently. I will discontinue asking if you can please reassure me one last time that the water retention I fear so much is impossible and I am truly cured. I must stop monitoring my weight so closely and monitoring my fluids so much. I just want to believe I'm healthy and move on with my life.
Thank you so much for all your help. You have been so wonderful, wise, and kind.
Many many thanks,
XXXX
Brief Answer:
Read as follows:
Detailed Answer:
Hello XXXXXXX
As you are feelings physically quite normal, my advice is to keep performing frequent physical activity, because this is the right way to relieve your mind from all the unpleasant thoughts and fears on health issues.
I have given you all the necessary evidences how my opinion is covering your concerns.
Probably you need to review them calmly, instead of fearing too much of already clarified details.
I hope you will find all the necessary willpower to overcome your bad memories and persistent fears.
To conclude, I would like to assure that you don't need to closely monitor your body weight or daily fluid amount intake, as there is no logical reason to fear about heart failure recurrences; fluid overload.
Kindest regards,
Dr.Iliri
Read as follows:
Detailed Answer:
Hello XXXXXXX
As you are feelings physically quite normal, my advice is to keep performing frequent physical activity, because this is the right way to relieve your mind from all the unpleasant thoughts and fears on health issues.
I have given you all the necessary evidences how my opinion is covering your concerns.
Probably you need to review them calmly, instead of fearing too much of already clarified details.
I hope you will find all the necessary willpower to overcome your bad memories and persistent fears.
To conclude, I would like to assure that you don't need to closely monitor your body weight or daily fluid amount intake, as there is no logical reason to fear about heart failure recurrences; fluid overload.
Kindest regards,
Dr.Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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