Borderline LVH by atenolol or SSRI? - Heart Disorders Message Board

Wildfire3323 · 01-18-2009, 08:41 PM

I have been on atenolol 75-100 mg since my mid 20's (now 40) for what was presumed SVT. But, I have seen cardiologists who did not agree with that, but kept me on atenolol anyways for tachycardia. I had an echocardiogram and Holter monitors back then which showed nothing in particular. My mom was recently diagnosed with CHF, and I had been really tired for the past few years and wondered if it could be cardiac related, so I had another echo. This time it showed mitral valve redundancy, with no MVP, and borderline LVH. I do not have HTN, never have, especially since I have been on atenolol. I have been on an SSRI also for the past 9 years or so (Paxil, Zoloft, and now Celexa for panic disorder). Ejection fraction was normal at 60-65%. Chamber sizes i believe were normal also. Any idea what this could mean? I'm also not big into exercising...so..should I be worried? Incidentally, we have no cardiologist in town, though some do visit throughout the year. Due to panic disorder, no way could I fly to visit one. I do have an appt. with an internal med, but I'm sure that only goes so far. ....any opinions? I'm worried about myself and my mom...

GodHand · 01-19-2009, 02:54 PM

With that ejection fraction, your heart is pumping at a good level. You have a strong heart and nowhere near any sort of failure limit.

LVH could be caused by many things, though I have not heard of SSRI's causing such a case. I am assuming since you said your ventricular chamber size is normal, you must have some thickening.

It's important to determine the cause. Do you have high blood pressure? That can cause LVH and can be reversible if your blood pressure is then controlled via medication and lifestyle changes.

Your heart is not the cause of your tiredness.

Wildfire3323 · 01-19-2009, 04:29 PM

No, not HTN. Been on atenolol for many years, so BP has been controlled. Though I am taking it for tachycardia...or assumed tachycardia. I had quite a stress load back then and also started having panic attacks around the same time...

Wildfire3323 · 01-19-2009, 04:34 PM

I copied a pasted my echo...

2-D: Underlying rhythm is normal sinus rhythm. There is no pericardial effusion. The mitral valve appears slightly redundant, but I not really appreciate any mitral valve prolapse on either the parasternal long axis, apical three-chamber, or apical four-chamber windows. The aortic valve is trileaflet with no unusual calcifications. Pulmonic and tricuspid valves appear normal. Chamber size is normal throughout. There is borderline concentric left ventricular (LV) hypertrophy. There are no segmental wall motion abnormalities and left ventricular systolic function is well-maintained, with ejection fraction estimated between 60% and 65%. No left ventricular or left atrial thrombus is identified.

M-MODE: The aorta has normal excursion. The aortic valve closes in the midline with no unusual calcifications. Aortic diameter in diastole is 29 mm and left atrial diameter in systole is 24 mm. The posterior mitral valve leaflet has normal motion. The anterior mitral valve leaflet has normal excursion and E-F slope. E point septal separation is 5.1 mm. The right ventricle measures 20 mm in diastole and 12 mm in systole. The intraventricular septum is 12 mm in diastole and 17 mm in systole. The left ventricle is 43 mm in diastole and 29 mm in systole. The left ventricular posterior wall is 14 mm in diastole and 18 mm in systole.

DOPPLER: Flow across the pulmonic valve is laminar with physiologic pulmonic regurgitation. There is trivial tricuspid regurgitation. Flow across the mitral valve is laminar, with peak E velocity 0.63 m/s and peak A velocity 0.50 m/s. There is trivial mitral regurgitation. Flow through the LV outflow tract is laminar. There is no indication of aortic stenosis or regurgitation.