Question: I'm a first timer here and would appreciate any assistance. I'm a 35 year old male, weighing 250lbs and 5'11 in height. I don't smoke, drink or use street drugs. A little history: I was hospitalized in 2012. I felt chest vibrations and was taken to the hospital. My
troponin level was elevated and all other tests (ekg, x-rays, stress-echo, coronary angio) were negative. I was then hospitalized 4 weeks ago with chest pressure. My troponin was elevated again. I believe both times my troponin elevated to .159. In any case, four weeks ago they performed x-rays, ekg, and
echocardiogram, all results were normal. I saw my primary physician two days later and my troponin level came back as normal. I just had a
stress test performed last Wednesday and the cardiologist gave me results that concerned me. He then said that the hospital didn't perform the echo correctly. I was like......ok...... Before I post the results, is there any sickness that can cause an increase in measurements within a four week span? Did the cardiologist take different measurements than the hospital? Did the hospital really make an error? I heard cardiologist is top notch, but then the hospital is known for excellent heart care. I'm at a loss about what to think. I spoke to my doctor today and she didn't know why the results from four weeks ago differ from today. She submitted for an extra echocardiogram today.
Test Results:
Clinical and Hemodynamic Findings: Baseline HR of 66 bpm increased to to 166 bpm after 6 minutes 30 seconds. This corresponds with 89% of MPHR. Baseline BP of 117/78 increased to 160/80. No
chest pain. Exercise was discontinued because of fatigue and
dyspnea.
Electrocardiograph Finding: Baseline ELG showed normal
sinus rhythm with RSR prime patterns in leads V1 and V2. No ischemic changes or dysrthymia was seen.
Echocardiographic Findings: Baseline echo showed moderate LA dilation of 4.6 cm, normal LV size of 4.2 cm, mild LVH, normal wall motion and EF of 60%. Diastolic function and RV motion is normal. Valves have normal appearance with mild MR and TR and estimated RV pressure of 35mmHg. Post stress images demonstrate normal response.
Discussion: (1) Exam negative for
ischemia (2) Fair exercise capacity (3) Moderate LA dilation with mild LVH. Normal LV size and EF of 65% (4) Normal appearance of valves with mild MR and TR and estimated RV pressure of 35mmHg.