Change in LV size

[Nupur]

I had my six month ECHO today (last one was a TEE). I asked the technician who was doing the echo if she would tell me the LV size. She said it is 5.1cm at the most distended (LVEDD?). When I told her that in Sept it was 4.9cm, she said that such a change is nothing and can depend on the fluid level in your body. Of course, my cardio is going to look at everything and speak to me, but that was her opinion. I probed a little more about fluid levels and LV size, and she said if I was dehydrated the size could be little smaller, and since my last reading was during my TEE without fluids, it could be the effect of that. Any thoughts on that?

Also, a does a difference of 4.9cm and 5.1cm count as an enlargement trend, or is it within the margin of error?

 

[Eva]

Hi Nupur,

I personally would not put emphasis on this change. Also, from my last experience with these technicians, I would never ever ask them anything about the test and wait for cardio's interpretation.

 

[Nupur]

Thanks Eva. I was surprised to hear about the fluid effect on LV size, but then I did ask her opinion : ) I have no idea what change in size is beyond the margin of error, but you are right, I should leave it to the cardio to interpret it for me.

 

[Nupur]

I picked up the report that has the cardio's intepretation of the ECHO.
The only number that has changed is the LVEDD.

LVEDD : normal range is 3.5 - 5.7 cm
My last echo was 4.9 and now it is 5.1, still within normal limits.

However, and this is something I should ask the surgeon, does the heart size depend on gender and general body size and so on? Is 5.1 still normal for a small frame woman?

 

[Ross]

It's not significant even if it is accurate. It depends on the tech, positioning of the body and how the organs press against your heart, so on and so forth. I wouldn't worry about it. I'll have to check to see if there is anything set in stone about normal values.

 

[Nupur]

Thank you Ross. Btw, welcome back. I was beginning to wonder where you are!

 

[deek]

My LVEDD has varied from echo to echo...for example, last July it was 5.2, next echo was 4.6, 4.8, 5.4. 4.8 and the last TEE showed 5.2cm...frustrating...I know...and I, too, am a small framed woman. My surgeon said to throw all the echos away, stop worrying about the numbers and get the operation as there is enlargement...

 

[Nupur]

Dee, so on what basis does the surgeon think there is enlargement? I thought it's those numbers that tell you. I guess it's not as clear cut as that. My cardio has clearly said she is not recommending surgery at this point, but I am seeing the surgeon next week anyway.

 

[deano89]

cant add much but when i asked the doctor who was doing my TEE what the measurements were that indicate surgery she replied its not just about specific meaurements but an overall picture of how the heart is functioning ,at my first echo the doctor said the LV was enlarged slighty and my heart was dynamic at the TEE it was normal and my heart was not hyper dynamic but they are still recommending surgery !!confused i am !the only reason he gave for surgery was mild pulmonary hypertension which was also from the first echo! , they couldnt get a lung pressure reading from TEE , i have the angiogram next wednesday so should get more info then, then i will meet with the surgeon

 

[Ross]

I picked up the report that has the cardio's intepretation of the ECHO.
The only number that has changed is the LVEDD.

LVEDD : normal range is 3.5 - 5.7 cm
My last echo was 4.9 and now it is 5.1, still within normal limits.

However, and this is something I should ask the surgeon, does the heart size depend on gender and general body size and so on? Is 5.1 still normal for a small frame woman?

Everythinig I've checked says something different, so there can't be anything set in stone as normal. The range you have above seems to be representative of what I've found everywhere else.

 

[deek]

Nupar, I think you'll find that your surgeons opionion will vary considerably from your cardios...at least mine did. The reason I was reluctant to accept my cardios opinion is that I'm very symptomatic...my situation is complex in that I'm also battling malignant/refractory hypertension which makes the regurgitation worse. Also, my pulmonary pressures are up there, 59mmHg to 69mmHg. As for the enlargement, I guess he's looking at the overall picture...in '07 my LVEDD was 4.2cm and the latest echo indicated 5.2cm. According to my cardio's this is still within normal limits but my surgeon sees everything as black and white and to him this shows that the heart is enlarging and his feeling is why wait? Again, although our situations are quite similar...the bi-leaflet prolapse, level of regurgiation and overall measurements, I am symptomatic and dealing with AH and PH.

 

[Nupur]

Deek, I am sorry about the pulmonary hypertension and the added burden on the valve. Regarding symptoms, I have come to realize that I am symptomatic too, I had just learned to live with it. Now that I know what is going on, I understand why I have to stop after a flight of stairs or why I feel so bad when I carry things like grocery bags or laundry baskets. All the best to you!

Ross, thanks for doing the research.

 

[Eva]

Hi Nupur,

I looked at my echo tests and my left ventricle was 5.8 in 2005 (the high norm 5.7) and my left atrium was 4.5 (the high norm 4)?the cardio still did not recommend surgery?his reasoning was that I was functioning OK! I wonder if I had seen a surgeon then and sought his opinion! Or at least insisted on seeing one in 2007 when my fatigue started worsening. I was informed I needed surgery within 6-12 months when my left ventricle became 5.48 (high normal according to this different clinic is 5.2) and my left atrium 5.13 (high norm 4.09).

Keep us posted