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What Does This Echocardiogram Report Indicate?
Question: My echocardiogram read moderate hypokinesis. LV normal size EF 35% mitral valve abnormal mobility, thickened leaflets. What does this mean? What question should I ask my cardiologist? What could be the cause?
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully reviewed you cardiac ultrasound report and could explain that your left side heart (left ventricle) demonstrates a decreased function (EF 35%).
This means that you may actually or in the near future suffer from what is called heart failure (expressed by exertional or resting shortness of breath, profound weakness, possible cardiac arrhythmia, limbs edema, etc.).
Could you explain please, besides your tachycardia, have you ever experienced recently any of the above mentioned complaints?
There are several reasons, why your ECHO report shows those abnormal changes.
This may be explained by a potential complication called peripartum cardiomyopathy.
It may also be caused by any infectious agent (viral, bacterial, etc), but in such case associated clinical symptomatology would be obvious.
Have you experienced any infectious disorder recently? Fever? Flu-like episodes?
Several endocrine disorders (thyroid, parathyroid, adrenal, diabetes, etc) may lead to such an echo result.
Also some autoimmune disorders may cause myocardial involvement and decreased cardiac function.
Special immunological tests (detecting underlying antigens and autoantibodies) could clarify this issue.
Regarding the other components of your heart (valves, pericardium, great vessels, etc.) they don't demonstrate any significant changes (even mitral valve, though with thickened leaflets doesn't show any stenotic or regurgitant dysfunction).
A cardiac MRI with late gadolinium enhancement would clarify any responsible causes in addition to lab tests for the above mentioned possibilities (endocrine, autoimmune, infectious, etc).
Hope to have been helpful to you!
You need to discuss with your attending doctor about the above mentioned options.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully reviewed you cardiac ultrasound report and could explain that your left side heart (left ventricle) demonstrates a decreased function (EF 35%).
This means that you may actually or in the near future suffer from what is called heart failure (expressed by exertional or resting shortness of breath, profound weakness, possible cardiac arrhythmia, limbs edema, etc.).
Could you explain please, besides your tachycardia, have you ever experienced recently any of the above mentioned complaints?
There are several reasons, why your ECHO report shows those abnormal changes.
This may be explained by a potential complication called peripartum cardiomyopathy.
It may also be caused by any infectious agent (viral, bacterial, etc), but in such case associated clinical symptomatology would be obvious.
Have you experienced any infectious disorder recently? Fever? Flu-like episodes?
Several endocrine disorders (thyroid, parathyroid, adrenal, diabetes, etc) may lead to such an echo result.
Also some autoimmune disorders may cause myocardial involvement and decreased cardiac function.
Special immunological tests (detecting underlying antigens and autoantibodies) could clarify this issue.
Regarding the other components of your heart (valves, pericardium, great vessels, etc.) they don't demonstrate any significant changes (even mitral valve, though with thickened leaflets doesn't show any stenotic or regurgitant dysfunction).
A cardiac MRI with late gadolinium enhancement would clarify any responsible causes in addition to lab tests for the above mentioned possibilities (endocrine, autoimmune, infectious, etc).
Hope to have been helpful to you!
You need to discuss with your attending doctor about the above mentioned options.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My thyroid was checked that was normal. Had blood work UPS done all normal. Haven't been sick or flu like symptoms. High heart rate was discovered at a reg doctor visit.
Only symptoms I have has is shortness of breath and feeling tired. No edema nothing else was found to be wrong. They mentioned the one that arises during or shortly after pregnancy. But was fine all thru pregnancy and check UPS after. Had a tubal done so no more children.
Only symptoms I have has is shortness of breath and feeling tired. No edema nothing else was found to be wrong. They mentioned the one that arises during or shortly after pregnancy. But was fine all thru pregnancy and check UPS after. Had a tubal done so no more children.
Brief Answer:
My opinion:
Detailed Answer:
Hi again,
As you are experiencing shortness of breath and tiredness, facing the reduced LV EF on cardiac ECHO report, it may be concluded you are suffering from heart failure.
Coming to this point, a differential diagnosis (considering several reasons, as I explained you above at the beginning of our thread) should be done.
Every normal parameter already checked (including thyroid hormones) should be exclude from further lab checkup.
As I mentioned you above cardiac MRI with late enhancement could give important clues in defining the exact myocardial involvement (subendocardial, transmural, or no-hyperinhancement, etc) concluding with a great accuracy for a possible responsible cause.
Etiological diagnosis of heart failure is done by exclusion (excluding possible factors one by one).
If nothing obvious could be concluded then great suspicions about peripartum cardiomyopathy remain.
Just to make you clear when discussing with your doctor, I am giving below the criteria for diagnosing peripartum cardiomyopathy.
(1). Heart failure develops in the last month of pregnancy or within 5 months of delivery.
(2). Heart pumping function is reduced, with an ejection fraction (EF) less than 45% (typically measured by an echocardiogram).
(3). No other cause for heart failure with reduced EF can be found.
Regards,
Dr. Iliri
My opinion:
Detailed Answer:
Hi again,
As you are experiencing shortness of breath and tiredness, facing the reduced LV EF on cardiac ECHO report, it may be concluded you are suffering from heart failure.
Coming to this point, a differential diagnosis (considering several reasons, as I explained you above at the beginning of our thread) should be done.
Every normal parameter already checked (including thyroid hormones) should be exclude from further lab checkup.
As I mentioned you above cardiac MRI with late enhancement could give important clues in defining the exact myocardial involvement (subendocardial, transmural, or no-hyperinhancement, etc) concluding with a great accuracy for a possible responsible cause.
Etiological diagnosis of heart failure is done by exclusion (excluding possible factors one by one).
If nothing obvious could be concluded then great suspicions about peripartum cardiomyopathy remain.
Just to make you clear when discussing with your doctor, I am giving below the criteria for diagnosing peripartum cardiomyopathy.
(1). Heart failure develops in the last month of pregnancy or within 5 months of delivery.
(2). Heart pumping function is reduced, with an ejection fraction (EF) less than 45% (typically measured by an echocardiogram).
(3). No other cause for heart failure with reduced EF can be found.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So my cardiologist is uping the metoprolol to 50mg isssued more blood work to be done. And wants to wait a month to do MRI to see if any improvement after some time of my heart rate being down. Basically is saying may not be a known cause and control with meds see if it improves. Definetly dont feel at ease. He first thought is the one from pregnancy. The other I didn't catch the name of. Seems to be wait n see if any improvement. Says I'm an in what's considered heart failure
2 things he believes it could be tachycardia- mediated cardiomyopathy ot peripatum cardiomyopathy
Also stated that the mitral valve leflets thickening was not significant and happens with ago. Sorry multiple msgs
2 things he believes it could be tachycardia- mediated cardiomyopathy ot peripatum cardiomyopathy
Also stated that the mitral valve leflets thickening was not significant and happens with ago. Sorry multiple msgs
Brief Answer:
I would explain:
Detailed Answer:
Hi,
As I explained peripartum cardiomyopathy seems to be a possible cause.
Regarding tachy-cardiomyopathy, I am not sure it could be a reason, because abnormal tachycardia needs to be persistent for a relatively long period of time to produce such LVEF alterations.
Nevertheless, when tachycardia is properly controlled, all the underlying changes could be reversed and cardiac function improvement would be seen.
The strategy proposed by your doctor seems reasonable; a correct heart failure treatment and a careful follow up by cardiac ultrasound, investigation by cardiac MRI could yield better results regarding clinical outcomes and diagnostic process.
Please, let me know about further uncertainties and how things are going on.
Wishing all the best,
Dr. Iliri
I would explain:
Detailed Answer:
Hi,
As I explained peripartum cardiomyopathy seems to be a possible cause.
Regarding tachy-cardiomyopathy, I am not sure it could be a reason, because abnormal tachycardia needs to be persistent for a relatively long period of time to produce such LVEF alterations.
Nevertheless, when tachycardia is properly controlled, all the underlying changes could be reversed and cardiac function improvement would be seen.
The strategy proposed by your doctor seems reasonable; a correct heart failure treatment and a careful follow up by cardiac ultrasound, investigation by cardiac MRI could yield better results regarding clinical outcomes and diagnostic process.
Please, let me know about further uncertainties and how things are going on.
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The test results came back from the other blood workups he did everything was within normal range except for my BUN which was a 4.
Brief Answer:
BUN is OK.
Detailed Answer:
Hi again dear,
I would like to assure you that a BUN (blood urea nitrogen) value of 4 mg/dl is not any indicator for a health disorder. It simply denotes a slightly decreased amount of proteins break down by the liver (the place where urea is produced by ammonia).
So, in such case your liver and kidney function is quite perfect and you shouldn't worry about.
Just relax!
Your already performed tests show optimal clinical conditions.
Hope you are having a nice time!
Greetings!
Dr. Iliri
BUN is OK.
Detailed Answer:
Hi again dear,
I would like to assure you that a BUN (blood urea nitrogen) value of 4 mg/dl is not any indicator for a health disorder. It simply denotes a slightly decreased amount of proteins break down by the liver (the place where urea is produced by ammonia).
So, in such case your liver and kidney function is quite perfect and you shouldn't worry about.
Just relax!
Your already performed tests show optimal clinical conditions.
Hope you are having a nice time!
Greetings!
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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