Doctors report: Please Review?

[elliottj]

Here is the doctors report from my first Echo on 9/01/2006

Echocardiogram is performed with 2D echo and color-flow Doppler

Chamber evaluation reveals enlargement of the left atrim at 4.8 cm
and enlarement of the left ventricle at 6.4 cm

There is concentric myocardial contractility with global ejection fraction of 74 percent

Valvular evaluation reveals a bicuspid aortic valve. There is moderate to severe aortic insufficiency with pressure half-time of 294 msec. No aortic stenosis is noted.

There is a mild mitral and tricuspid insufficiency.

Hepatic veins and vena cava are normal. There is no pericardial effusion.


Please respond with comments and concerns to help shed some light on this report... you all have a wealth of knowledge and I would love to hear what others think.

Thanks in advance,
Jay

 

[Steph]

Hi Jay,

I can't help you with your numbers, sorry. However not too long ago someone posted a link to a web site the gave number ranges for heart measurements, if I can find that I will send it your way. Maybe someone else has it at their fingertips. Good luck.

Steph

 

[Steph]

This might help, forgive me if it doesn't work.

http://www.echobyweb.com/htm_level2_eng/normal_parameters_tt.htm

Steph

 

[Phyllis]

This guidline for when it is time to operate should help too: http://www.emexcardio.org/artikel_apicon1.htm

 

[tobagotwo]

Chamber evaluation reveals enlargement of the left atrium at 4.8 cm
and enlarement of the left ventricle at 6.4 cm

There is concentric myocardial contractility with global ejection fraction of 74 percent

While your regurgitation is listed as only moderate-to-severe, your heart is enlarging, both with left ventricular hypertrophy and atrial enlargement, due to the regurgitation (insufficiency, leakage). Your ejection fraction is at 74%, which is high, but not in a good way. It's part of a cycle of hypertrophy that ends (eventually) in heart failure. The remark about concentric contractility means your heart walls are still limber, which is a good thing.

I get concerned about the atrial enlargement, as the atria do not usually remodel as well or as fully as the ventricles. Enlarged atria can encourage arrhythmias even after surgery.

You're getting closer to your time. If they haven't told you to go looking yet, I hope they're at least rechecking your status every six months. I would consider a second opinion, or at least pressing the doctor for his guess at how much time before intervention.

You are likely having some symptoms at this point. Be sure your doctor is aware of them, and don't downplay them.

Best wishes,

 

[MrP]

You should consider aortic vavle replacement surgery sooner than later to avoid more damage to your left ventricle and left atrium. After surgery, my left ventricle continued to remain enlarged, and my left atrium increased in size immediately afterwards and then became smaller over the past two years. You didn't mention the size of your aortic root or ascending aorta. With BAV, my recommendation is to have a CT scan w/ contrast in order to accurately determine if you have aneurysmal dilation of your ascending aorta.

If you elect to wait to have surgery, you risk permanent damage of your heart due to hypertrophy.

Normal range of LV-d is 3.7 - 5.6cm, LV-s is 2.4 - 4.2cm, left atrium is 2.0 - 3.8cm.

Regurgitation (insuffiency) is due to your bicuspid aortic valve, and your LV is enlarged from the regurgitation.