Hello I am a new user here and would like some advice on what to do. I am a 26 years old male. The bolded results are the ones that I am concerned about. Here is my not so brief medical history begining In 2008. I went to a new Doctor due to symptoms of palpitaitons, chest pain and a newly discovered murmur. He could not hear the murmur and told me I was just hearing things, but gave me an echo to ease my mind. Here were the results from 2008:
1. Left ventricular systolic function is normal.
Left Ventricle - Structure and Systolic Function: Left
ventricular systolic function is normal. Overall left ventricular
ejection fraction is estimated to be about 55%. No regional wall
motion abnormalities are seen.
Left Atrium: Left atrium is normal size.
Right Atrium: Right atrium is normal size.
Right Ventricle: Right ventricular size and systolic function is
Aorta: The aorta appears structurally normal.
Aortic Valve: The aortic valve is has three leaflets and appears
normal. Trace aortic valve insufficiency.
Mitral Valve: The mitral valve leaflets have normal appearance
and mobility. There is no mitral regurgitation.
Tricuspid Valve: The tricuspid valve is structurally normal.
Trace tricuspid regurgitation is present. The peak gradient is
22.1 mmHg , thus right ventricular systolic pressure is 22.1 mmHg
above the right atrial pressure.
Pulmonic Valve: The pulmonic valve is not well visualized.
Pulmonary Artery: There is no elevation of pulmonary artery
pressure. The pulmonary artery systolic pressure is 30.1 mmHg.
IVC/Hepatic Veins: The IVC is normal in caliber and has normal
response to respiration.
Pericardium: No pericardial effusion seen.
M-Mode Dimensions Diastole Systole Normal Range
RVID 1.50 < 3.0 cm diast.
LVID 5.00 2.85 < 5.6 cm diast.
LA 2.55 < 4.2 cm syst.
AO 2.55 < 4.0 cm diast.
IVS 0.85 < 1.2 cm diast.
LVPW 0.90 < 1.1 cm diast.
EPSS 0.55 < 0.6 cm
FS 43.0 25 - 53 %
2D Diastole Systole Normal Range
RVAW 0.2 to 0.7 cm diast.
RV 1.63 1.9 to 3.8 cm diast.
IVS 0.76 0.6 to 1.1 cm diast.
LV 5.01 3.32 3.5 to 6.0 cm diast.
LVPW 0.86 0.6 to 1.1 cm diast.
Ao Root 2.81 2.1 to 3.4 cm diast.
LA A/P 2.75 2.3 to 3.8 cm syst.
LA Area A4C 8.8 to 23.4 cm2 syst.
LA Volume 28 to 48 cc
I wanted a second opinion and changed my primarycare physician. I told my new Doc about my symptoms and that I thought I might have Marfan Syndome so he gave me another echo to rule out aneuysm/dissection and referred me to a geneticist. Here is my second echo from 2008:
LV- sytolic function normal. LV cavity size normal.Ventricular wall thickness normal.LV systolic function normal. Overall LV ejection fraction esstimated 55 to 60%.
LV- Diastole: LV isovolumetric relaxation time prolonged at 104msec. The doppler derived earl diagnostic time is prolonged.
Aorta: The aortic root diameter is normal,measuring 3.22cm no evidence of dissection.
Aortic Valve: Has three leaflets and appears normal. Mild aortic valve insufficiency. The pressure half-time of velocity envelope of the aortic insufficeny jet is 753 msec. The noncoronary and right
coronary cusps failed to coapt completely.Peak systolic graident 8.3mmhg, and mean systolic gradient is 4.0mmhg.
Pulmonic Valve: is not well visualized. Mild to moderate pulmonary regurgitation is seen.
Trip to the geneticist and a gene test only confirmed a 10% chance of marfan syndrome, which my geneticist just recently told me i was unlikely affected by it, due to my history of stable aortic root
size, and no longer needed annual echo checkups. I was really glad to hear the news, but my symptoms of chest pain, daily palpitations, migraine with aura, sob when exercising, feeling of blood pooling in head, chest pain when jumping, still bothered me. THree echos, CT of aorta, and MRI angio of brain and carotids later Here were the results:
2009 echo findings:
LV Ejection Fraction 60 to 65%
Aaortic Valve: THe aortic valve is native and bicuspid. Right and Left coronary cusps are partially fused. Trace Aortic Valve insufficiency.
Aortic Root measured 3.10 cm.
Pulmonic Valve is normal no regurgitaiton is seen.
2010 Echo findings:
Left Ventricle - Structure and Systolic Function: The left ventricular cavity size is normal. Ventricular wall thickness is normal. Left ventricular systolic function is normal. Overall left ventricular ejection fraction is estimated to be about 60%.
Left Ventricle - Diastole: The overall diastolic pattern is onof normal left ventricular relaxation.
Aortic Valve: Mild aortic valve insufficiency.
Aortic Root measured 3.22 cm.
Newest and Last 2011 echo findings:
Normal left ventricular wall thickness.
Normal left ventricular size.
Normal LV systolic function with a visually estimated ejection
fraction of 65%.
Normal wall motion.
Normal diastolic filling indices.
Normal right ventricle structure and function.
The ascending aorta and the visualized portion of the arch is
normal in caliber and contour. There is no evidence of
coarctation by spectral Doppler.
Trace aortic insufficiency otherwise normal valves.
Normal pulmonary artery pressure.
Compared with previous echocardiogram performed on 8/17/2010
there is no significant change.
Aortic root 3.22cm.
CT and MRI didn't find anything significant.
I asked my PCP about my murmur and BAV findings in 2009 and he said it was a normal finding and nothing to worry about. Sorry for the long history, but now I am not sure how I should continue with my doc. I still have chest pains, heart palpitaitons, shortness of breath, murmur, migraine with aura, dizziness/lightheadedness. Do I have a BAV or don't I and if I do will it get worse over time? Should I not lift weights/run? Do I need to see a cardiologist? Or am I just overreacting to all of it? What do you guys think I should do? Thanks for reading any advice is appreciated.