HELP NEEDED PLEASE : LVH Questions

10-04-2006, 02:05 PM

Had an echo, results follow:

1) Left Atrial Dim: 5.0
2) Ao Root Dimension: 3.4
3) Aortic Root: Normal
4) Left Ventricle: Dilated, Mild LVH, Decreased Compliance
5) Mitral Valve: Mild Regurgitation
6) Triscupid Valve: Mild Regurgitation
7) Pericardial Effusion: None
8)Aortic Valve Amplitude: 2.0
9)LVID in Diastole: 5.7
10)KVID in Systole: 4.2
11)Thickness of IVS: 1.3
12)Thickness of Posterior Wall: 1.3
13)Left Atrium: Dilated
14)Right Ventricle: Normal
15)Interventricular Septum: Hypokinetic
16)Post LV Wall: Hypokinetic
17) Aortic Valve: Normal structure and function
18)Pulmonary Valve: Normal structure and function

Decreased LV Compliance
Mild LVH
Dilated Left Ventricle and Atrium
Mild Mitral and Triscupid Regurg.
Hypokinetic Interventricular Septum - Post LV Wall
LV Normal in Function - EF approx. 50%

________________________________________ _________________________

Following Dipyridamole Dual Isotope Myocardial Perfusion Scan, results folllow:

1)Review of SPECT imaging reveals large in size, moderate in severity anterior wall defect with complete reversibility associated with a large severe interior wall defect without resersibility.

2)Mild pulmonmary uptake and the ventricle is dilated at both stress and rest.

3)Review of gated imaging reveals diffuse global hypokinesia especially of the inferior eall, with an EF of approx 25%

Conclusion:

A) Negative pharmacological imaging with respect to symptoms end electrrocardiographic changes.

B) Myocardial perfusion revelas a large in size, moderate in severity anterior wall defect with complete reversibility associated with a large inferior wall defect without reversibility consistent with ischemia in the distribution of the anterior descending coronary artery and infarction in the distribution of the right coronary artery.

C) Gated imaging reveals severe diffuse global hypokinesis, especially of the inferior all with an EF of approx. 25%.

I am on a strict weight loss program.. A1c has been approx 6.2% since 6/13/06. Average BP has been 112/70 since 6/2006. Exercising for approx 1 hour per day. 7 days per week. LDL 73..HDL 51. No Blockages.

Can anyone help with interpretaion of results???

10-04-2006, 02:59 PM

Hi,

Similar to my report 2 1/2 years ago except I had severe Mitral valve regurgitation also.

Your EF is approx. 25%. Means about 25% of the blood in the left ventricle is pumped out with each heart beat. 55 to 75% is normal...below 30% is heart failure.

Ischemia (lack of blood supply) due to blocked coronary artery (left side). Right side shows infarction (muscle damage).

Left ventricle: mild enlargement, decreased pumping ability (consistent with the low EF).
Left atrium (upper chamber). Slightly enlarged..consistent with low EF.
Valves are OK. Slight regurg, not significant.

B) Myocardial perfusion revelas a large in size, moderate in severity anterior wall defect with complete reversibility associated with a large inferior wall defect without reversibility consistent with ischemia in the distribution of the anterior descending coronary artery and infarction in the distribution of the right coronary artery.

Apparently you had a heart attack due to ischemia from blocked arteries. Much of the report describes the area deficit of sufficient oxygen supply. But you state you do not have any blocked arteries?

10-04-2006, 03:05 PM

Had a cath in May 2006. Cardiologist said that there was no blockage or narrowing of the arteries present. He also stated that he would have felt better if there was a blockage.

10-05-2006, 08:36 AM

That poses the question if there is ischemia (lack of blood flow) causing hypokinesis (heart wall motion impairment) what has caused or causes the deficit blood/oxygen that would be the underlying reason for the hypokinesis?

It is probable there is heart muscle damage due to a present or past viral infection, alcohol, drugs or medication, prior illness, etc. The report states negative pharm. imaging with respect to symptoms and EKG changes. That kind of limits to prior or present illness. Possible it is ideopathic (cause unknown). Obviously there will be a continuation to decern the cause.

10-06-2006, 05:27 AM

Rsabatini,

You have a conflict. Your echo shows a heart attack caused, presumably, by a total blocking of the Right Coronary Artery.
Earlier in this year you had that artery declared blockage-free on a catheter angiogram.

Either one of these is wrong, or else you suffered a heart attack from a clot that recently and suddenlt lodged in your right coronary circulation.

Call your cardiologist and present him with this evidence and get his opinion.

I think you need a tiebreaker here. It seems a second angiogram might be necessary...maybe by somebody else?

(My GUESS is that the catheter angio missed the major blockage. )

What caused you to seek these tests?

KK,
What does "with complete reversibility" mean with regards that anterior defect?

10-06-2006, 07:00 AM

Shortness of Breath brought me to my GP and an echo he perofrmed lwd to the Stress Test. Cath was a result of the echo and stress test results.

10-06-2006, 08:57 AM

Lenin and Rsabatini,

Reversable in context of heart muscle was stated in my report also. My research indicated it means blood flow returning to normal with rest. My reversibility was consistent with ischemia due vessel blockage.

Rsabatini's report to me indicates there is reversibility to a large area of perfusion (inferior wall defect), but does not reverse consistent with vessel blockage!?

10-06-2006, 05:53 PM

Quote:

Originally Posted by Rsabatini

Shortness of Breath brought me to my GP and an echo he perofrmed lwd to the Stress Test. Cath was a result of the echo and stress test results.

Has there been a biopsy of the heart muscle?

10-07-2006, 03:27 AM

No, A biopsy has not been performed.

HELP NEEDED PLEASE : LVH Questions

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