Enlarged LA - Heart Disorders Message Board

Toneman · 07-31-2007, 03:22 PM

Need your thoughts, I received a copy of my echo from last week and everything looks good within normal range with the exception of my left atium which was enlarged to 4.9 cm. No one seemed concerned and explained it could just be due to my daily exercise program. Even the LVH that they made a point of telling me about on the phone was only borderline and not a problem. EF is 63%, normal wall motion throughout, all other chambers and walls within normal size and function, all valves good except trace leakage in my tricuspid valve, everything else normal. I am a 49 yearl old male, non smoker, no early onset CAD history in family, blood pressure and cholesterol controlled.

How big of a deal is an enlarged LA?

Thanks in advance for your input.

Tony

started04 · 08-02-2007, 10:32 AM

Quote:

Originally Posted by Toneman

Need your thoughts, I received a copy of my echo from last week and everything looks good within normal range with the exception of my left atium which was enlarged to 4.9 cm. No one seemed concerned and explained it could just be due to my daily exercise program. Even the LVH that they made a point of telling me about on the phone was only borderline and not a problem. EF is 63%, normal wall motion throughout, all other chambers and walls within normal size and function, all valves good except trace leakage in my tricuspid valve, everything else normal. I am a 49 yearl old male, non smoker, no early onset CAD history in family, blood pressure and cholesterol controlled.

How big of a deal is an enlarged LA?

Thanks in advance for your input.

Tony

Tony, apparently from your posted results it appears there is no mitral valve stenosis or any other condition that would cause LAE. The cause may be unknown (ideopathic) and sometimes an athlete has an enlarged atrium. Normal dimension is 1.9-4.0.

The concern would be the risk of atrial fibrilation with LAE. An EKG would be helpful to determine "P" wave duration. A long duration (120 msec) would be a sign of a conduction delay and that can cause arrhythmia. Was there an EKG prior to the echo?

An arrhythmia risk aside the other concern would be an increase in left ventricle size and a falling EF percentage. That appears to be under control. My source comments blood pressure should be controlled and a good heart failure regimen (if there is a concern)?.

Toneman · 08-02-2007, 10:56 AM

kenkeith,

There is no concern of CHF. I just had not had an echo in the last 18 months and when I saw my cardiologist a couple of weeks ago for my annual check up for my blood pressure meds, she thought it would be a good idea to have an echo to "make sure my heart was as strong as it was last year". As part of my visit, I also had a normal EKG and even asked her about chamber size and she said nothing she saw on the EKG would lead to any enlargement diagnosis. Based on my weight loss through exercise and no symptoms she did not feel there was any need to repeat a stress test.

So I really don't know what to think, both my family doctor who received a copy of the report and the PA from the cardiologist that called me seemed completely unconcerned about the LA enlargement. The only thing they wanted to point out was the LVH at 1.2 cm, which is borderline/mild. The comments on the report concerning my mitral valve were "normal appearing mitral valve, significant insufficiency was not identified" so I assume that's good.

Any other thoughts?

Tony

started04 · 08-02-2007, 05:10 PM

Quote:

Originally Posted by Toneman

kenkeith,

There is no concern of CHF. I just had not had an echo in the last 18 months and when I saw my cardiologist a couple of weeks ago for my annual check up for my blood pressure meds, she thought it would be a good idea to have an echo to "make sure my heart was as strong as it was last year". As part of my visit, I also had a normal EKG and even asked her about chamber size and she said nothing she saw on the EKG would lead to any enlargement diagnosis. Based on my weight loss through exercise and no symptoms she did not feel there was any need to repeat a stress test.

So I really don't know what to think, both my family doctor who received a copy of the report and the PA from the cardiologist that called me seemed completely unconcerned about the LA enlargement. The only thing they wanted to point out was the LVH at 1.2 cm, which is borderline/mild. The comments on the report concerning my mitral valve were "normal appearing mitral valve, significant insufficiency was not identified" so I assume that's good.

Any other thoughts?

Tony

You have a DILATED left atrium and atrium's CAVITY is enlarged and discussed in the prior post.

The left ventricle at 1.2 cm relates to heart wall thickness (norm 0.6-1.1). The most common myocardiomyopathy is dilated LV (norm 3.3-5.7). You haven't provided that measurement so I assume that is within the normal range.

What you have is LV hypertrophy and that is an increase in heart muscle mass (wall thickness). The hypertrophy can obstruct blood flow from the LV. Also it can distort one leaflet of the MV (often hereditary) and cause regurgitation as well.

At the present time your LVH does not obstruct blood flow as your heart wall motion is normal and a normal EF. Your MV is structually normal and no MV insufficiency (leakage). That is good.

Toneman · 08-02-2007, 08:08 PM

Kenkeith,

You are correct, my LV is fine with a LVID of 4.7 cm. Is 4.9 cm for the LA a huge number?

Thanks,
Tony