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What Does My Echocardiogram Report Indicate?
Question: Hi, When I aerobically exercise my heart beat increases to in excess of 110bpm and remains at this level for up to 8 hours leaving me utterly exhausted. My echocardiogram showed no issues and a CT scan produced a low calcium score. My ecg showed no arrhythmias or abnormalities in the beat. Historically in 2001 and 2012 I have had severe afib episodes that had to be corrected by cardioversion. My GP believed the current exercise issue is due to electrical impulse issues in my heart, the cardiologist believes it to be a reaction to high blood pressure and therefore has increased my medication to 3 tablets including a beta blocker. Though my BP was when I visited the cardiologist it was not excessively high when I first started having the increased bpm issue after exercise.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome on HCM!
I passed carefully through your concern and would like to explain that as long as you are clinically normal and your already performed medical tests (resting ECG, echocardiogram, coronary angioCT) are normal, then you shouldn't worry about.
Now returning to your main point of concern: tachycardia, I would say that it is quite normal a proportional increase of heart rate with exertion.
With aerobic exercise it is quite normal a heart rate increase in excess of 110 bpm.
What remain questionable is tachycardia persistence even beyond hours from physical exertion.
Considering also your previous history of recurrent afib episodes, a rational explanation could be an altered modulation of your nervous vegetative system (which is responsible for controlling the automatic function of internal body organs, including the heart).
An increased ratio of sympathetic to parasympathetic system drive may lead to exaggerated catecholamines activity and thus persistent tachycardia.
This may also lead to a steady hyper-dynamic state favoring hypertension.
In addition, it may play a role in atrial arrhythmia triggering (such as afib, atrial tachycardia, etc.).
That's why your doctor has rightly decided to include a beta blocker as a necessary treatment.
In order to properly explore the level of an abnormal settings of the vegetative nervous system several tests would be helpful, such as:
- an exercise cardiac stress test,
- an ambulatory 24 to 48 hours ECG monitoring (Holter),
Also, some other lab tests should be reviewed as well:
- complete blood count (for possible anemia),
- PCR & ESR (inflammation),
- thyroid hormones level (possible thyroid dysfunction),
- blood electrolytes level
You need to discuss with your doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome on HCM!
I passed carefully through your concern and would like to explain that as long as you are clinically normal and your already performed medical tests (resting ECG, echocardiogram, coronary angioCT) are normal, then you shouldn't worry about.
Now returning to your main point of concern: tachycardia, I would say that it is quite normal a proportional increase of heart rate with exertion.
With aerobic exercise it is quite normal a heart rate increase in excess of 110 bpm.
What remain questionable is tachycardia persistence even beyond hours from physical exertion.
Considering also your previous history of recurrent afib episodes, a rational explanation could be an altered modulation of your nervous vegetative system (which is responsible for controlling the automatic function of internal body organs, including the heart).
An increased ratio of sympathetic to parasympathetic system drive may lead to exaggerated catecholamines activity and thus persistent tachycardia.
This may also lead to a steady hyper-dynamic state favoring hypertension.
In addition, it may play a role in atrial arrhythmia triggering (such as afib, atrial tachycardia, etc.).
That's why your doctor has rightly decided to include a beta blocker as a necessary treatment.
In order to properly explore the level of an abnormal settings of the vegetative nervous system several tests would be helpful, such as:
- an exercise cardiac stress test,
- an ambulatory 24 to 48 hours ECG monitoring (Holter),
Also, some other lab tests should be reviewed as well:
- complete blood count (for possible anemia),
- PCR & ESR (inflammation),
- thyroid hormones level (possible thyroid dysfunction),
- blood electrolytes level
You need to discuss with your doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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