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    What does my echocardiogram report indicate?

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Posted on Fri, 21 Jul 2017 in General Health
Question: Dear Dr Iliri,
This is my echo report from yesterday. I know it's normal and yet I am focused on how EF is 61- last time was 62, and over last two years has always always been
65-70. So doesn't this mean it has lowered a little? Would there be other signs as well if there were a true lowering of heart function? He told me the diastolic dysfunction is nothing too but my e/a ratio has gone from 1.41 two years ago to .8 yesterday. Isn't that something to worry about?

I have attached yesterday's echo with one from November 2016, and two years ago. It is just the last six months that EF is below 65-70 and the diastolic issue appeared.
Is there some slow decline happening?

Mostly I am trying so hard to not focus so much on water but I know on days I jab to stand all day for work, I am urinating less and it makes me try so hard to always sit. It is humiliating and so difficult.

Thank you so much for everything, Dr. Iliri.
Mia
doctor
Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
My opinion as follows:

Detailed Answer:
Dear Mia,

I am glad to confirm that your last echo shows a normal heart function and structure.

Normal left ventricular size and function. Normal ventricular filling pattern. Normal right ventricular size and function.

The EF 61% is within the normal ranges. It does not indicate any aggravation or any significant changes from your last echo. These little changes are related to the heart hemodinamic changes, but they are not indicative of any decline in the heart function and any other disorder. Inter-observer variability may be another explanation of these little changes.

Regarding the diastolic dysfunction, the E/A ratio is within the normal ranges (0.6-2). So, there is nothing to worry about!

Finally I agree with your doctor, on the fact that there are no changes between your previous echo and this echo.

So, just relax and try not to think too much about it!

The fact that you think that you are urinating less, it may be because of the hot weather and the increased sweating, which means that less urine is produced. But, your body seems to be in a great balance, as there is no signs of fluid retention (edema) and your last performed echo is quite normal.

You should be happy about it! Just push away those doubts from your head!

Everything seems to be OK!

Anyway, I am always here if you want to discuss again about this!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 2 days later
Dear Dr Iliri,
Thank you. I am trying not to focus so much on the numbers but I keep remembering when the numbers were so critical. When I was in the recovery room from my first ablation, my doctors came in to my room to say that in my post surgery echo a month later, I needed to see my EF of 15 improve to 25 to avoid needing transplant and 35 to avoid ICD. They joked "trophy if you hit 55". In one month, I did improve to 55-60. So 10 points is a measurable difference in EF, isn't it? I understand that 61 and 70 are both normal, but isnt going from 65-70 for two years, every echo, to 61 significant? If it went down further, just a bit, it would be on low side.

I read a troubling study that said the average EF for a woman my age is 70. I know average and normal isnt the same, but
doctor
Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
My opinion as follows:

Detailed Answer:
Dear Mia,

I understand your concern, but you should know that some little changes in EF have a different significance in heart failure patients.

But, they have not any clinical significance when the EF is within the normal ranges.

Those little changes are related to the heart hemodinamics changes in healthy and normal persons.

You should know that a normal EF is 55-75 %.

So, there is not a specific EF for women or man. If you have an EF above 55%, it means that there is nothing to worry about.

I don't think that your EF will change below these levels. It is just some little variations within the normal ranges, with no clinical significance.

It will not go down further!

You should try to push away those bad thoughts, which are playing a bad game inside your head. They are just supposition! It is because of your fears and the bad memories, which are pushing you into pessimistic predictions or suppositions.

But, nothing like that will happen. The truth is that you have a normal EF and your last cardiac ultrasound showed a normal heart structure and function, without any significant changes from the previous.

So, relax and don't worry about it!

As a cardiologist, I can assure you that nothing bad is going on!

Anyway, I am always here is you want to discuss again on these issues!

I wish you a nice weekend,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 3 days later
Thank you Dr Iliri. I dont know how to make myself feel less like I am on fhe brink of death. In the two and a half years since my diagnosis I havent relaxed for even one minute and I was led to believe that my constant weighing and knowledge of fluid status would be the only way I could stay alive.

Could someone like me with a poor history, in your opinion, greatly affect their daily heart strength, by strategically resting, intstead of walking/standing after drinking large volumes of water? I do this all day and night, trying to make sure I am "testing" myself by taking in large amounts of water (almost 4 L a day) while weighing myself constantly. It has stopped my normal life entirely as I have to adhere to my weighing/drinking/resting schedule with activity scheduled around weigh-ins.

Thank you Dr Iliri.

Mia
doctor
Answered by Dr. Ilir Sharka 4 hours later
Brief Answer:
My advice as follows:

Detailed Answer:
Dear Mia,

I understand how you feel, but I would like to explain that you have a normal heart function now.

This means that there is no need to weigh yourself continuously as your heart pumps blood properly and nothing bad will occur if you do not do this.

I don't think that all this repeated process (weighing, resting and activity) has made or will make any change to your clinical situation.

There is no need to do these rituals, because you can consider yourself a normal and healthy person now.

But, I understand the fact that you do these ritual because you are afraid that something really bad will going to happen if you do not do it.

As a cardiologist I would reassure you that nothing bad will happen if you stop weighing yourself.

You should try to live a normal life. Psychotherapy can help fight your fears and win your freedom from all these rituals.

It is time to live a normal life, like all the others. But you should try to believe this and make it real. It is up to you to fight all these fears. You can make it gradually: for example make up your mind and try not to weight yourself for 5 hours. The next day you can do this for 6 hours and so on. You will see that nothing bad will happen. This will encourage you to go on with this trial. I am pretty sure that if you believe, you can do it!

Let me know about everything!

I will be always here to discuss about it if you need me!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 2 days later
Thank you Dr Iliri,
I am trying so hard with therapy, and trying everything and it just feels like I will never be able to accept that what happed to me is over and I can live again.

I spend my days trying so hard to be still after I've had a drink - but if I were sick with heart failure, would it help with water retention or was my doctor wrong that I needed to rest to assure I could expel water?

So I think of water all day and weighing and measuring and then I think of my next echo because I feel sure the next time, my EF will have declined and everything I worry about will come true.

It is getting hard to continue living in this manner and if not for having a young son I raise on my own, I would simply not go on. It is too hard to live with such rigid rules and so much fear. I don't know how much longer I can go on living like this. I have lost all hope that I can live without rituals and constant fear. I feel like I came so close to dying that I was supposed to die- that I shouldnt be here. We are about to leave for a beach vacation but all I can think about is being able to adhere to my schedule while others are eating and playing and living spontaneously. I must drink on schedule and weigh and measure. I am tortured all day.

Thank you Dr Iliri, for all your help for such a long time. I wish I could tell you I was better and had hope. You've been so helpful and caring. Many many thanks.
doctor
Answered by Dr. Ilir Sharka 6 hours later
Brief Answer:
My advise as follows:

Detailed Answer:
Dear Mia,

I am really sorry to hear you talk about it this way.

Hope is all we have and we can not lose it! It makes us be alive, although we are not happy or in difficulties. Nobody can take it away from us.

As long as you are alive, there is hope that everything will be OK!

You have gone through a very difficult situation, but everything is past now. You are a normal and healthy person now.

The only concerning thing now are your fears, obsessions and compulsion, which are limiting your life. You have the force to fight them. It is inside you, but you just don't know it.

All these bad thoughts and fears are really easy to treat, compared to your past situations with your heart.

And your heart is OK now. You should try to be more optimistic.

If you are already taking an antidepressant, you should discuss wit your doctor on the possibility or raise the dose or switch to another one. Antidepressants have a wonderful effects in similar situations. They help made up your mind and see the good things, which you can not see now in your life. They are there. The truth is that you have a real life, a beautiful and healthy son, you are young with a good job and there is nothing to doubt on this. All the other things in your had are just some bad thoughts, which you ca not push away from your head.

As a cardiologist, I would like to explain that there is no need to control the fluids you take any your weight. It is not going to make any change in your body, because you have a strong heart now.

It could change something when you were sick in the hospital, but that is all over now. You should try to live like other healthy persons.

Go and enjoy your holiday with your son! Life is all about those happy moments! Don't miss them!

I am always here if you want to talk again about it! Don't hesitate to ask me!

Wishing a nice weekend,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7428 Questions

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