ECHOCARDIOGRAM RESULTS

Hiya guys and gals,

Now there are some very brainy peeps out there and so I’d like to invite comment on the following Echocardiogram results - in summary it says ......

1 severe concentric left ventricular hypertrophy. Left Ventricle not dilated and has normal systolic and diastolic function.

2 the Aortic Valve is trileaflet mildly sclerotic in appearance. Proximal ascending aorta is mildly dilated with maximum diameter of 3.75cm.

3 mitral valve normal appearance, left atrium borderline dilated.

4 basal aspect of right ventricle appears mildly dilated systolic function is normal. Trace of tricuspid regurgitation.

5 AN INCIDENTAL FINDING is the presence of a small pericardial effusion measuring at most 1.4cm which is not causing any haemodynamic compromise.

SUMMARY - As compared to the Echocardiogram of 2 years ago the degree of left ventricular hypertrophy has increased although I note his blood pressure today is normal at 142/72. No increase in Aortic dimensions which I do not think merits further routine echocardiographic surveillance.

So that’s it. My GP will have her copy too by now so my initial question to you guys and gals is, after 13 years of controlled AF with no surgical intervention where does this leave me ? and what reaction might I reasonably expect from my GP ?

Any input you may care to give would be welcome as there is obviously a conversation coming up. Thanks.

John

[jeanjeannie50]

Goodness John, that all means nothing to me. I hope someone here can give you some advice. I'm waiting for the result of my echocardiogram too, so will look with interest at the answers you get.

I think you generally feel well, don't you?

Good luck.

Jean

[Hidden in reply to jeanjeannie50]

Hi Jean,

After I had the ECHO I wrote to the company that did it and - independantly of what they sent to my GP I requested a copy to be sent to me direct via Royal Mail. Sorted.

What I got was a letter cover page which was a summary attached to which was all the professional medical jargon detail.

I was disappointed that it wasn't more glowing but as CD reminds me .... something I'm apt to put to one side ....I'm an old geezer 😂😂😂😂😂😂,

Yes, you are correct, I feel incredibly well, almost like an aged superman 😱😱 . When you get your results ( which took about 10 days for me to come through) you now have some inkling of what to expect. Hope yours is more glowing than mine 😂😂😂😂

John

[CDreamer in reply to Hidden]

I’d just point out to others that having known you for some time and met in person I took liberties in the knowledge that you might laugh rather than take offence.

[Hidden in reply to CDreamer]

Bless, I always laugh never take offence The more subtle the humour the better. Loved Clive James. Sometimes my humour gets me into trouble - probably my Australianess coming through. The weird thing is I feel so well, I feel fit and I'm still driving a bus ( college trips only 3 hrs morning/ 3 hrs afternoon 5 days a week), weekends and all holidays off. I pace myself when not on duty but TBH, there is only one thing that bugs me - I have been categorised with paroxysmal AF and asymptomatic. With these latest results I really have no symptoms, none! Is it possible to have the stuff listed in this Echo and be asymptomatic. ( Thats one question for my GP).

My bus an Enviro 500 nicknamed 'Bigbird'.

[CDreamer]

What I would take from that is you are doing ok for an old geezer who has had AF for a number of years.

I would look for continued monitoring every couple of years or so or if I started having symptoms such as fatigue, pain & breathlessness.

My own take is if it were me I would want my BP lower.

Do you want a breakdown of all the terminology?

[Hidden in reply to CDreamer]

If it isn't too much trouble or inconvenience then a break down as you describe would be ideal. Thank you so much.

[CDreamer]

PS - no mention of EF fraction so assume that was ok but you might ask?

[Hidden in reply to CDreamer]

CD, I have just looked at all the supporting papers and under the main heading of LV MEASUREMENTS there is a sub heading listed as EF(Teich) which shows 65.20%. Would that be it, I think so.

[CDreamer in reply to Hidden]

yes and that’s a good figure 👍. It’s a measurement of how your heart is pumping blood to your body & should be between approx 50-65%.

Hypertrophy - thickening of the muscle - probably because it’s working hard?

Aortic valve is a bit stiff - sclerotic - happens with age.

Aortic artery is mildly dilated - stretched.

basal aspect of right ventricle appears mildly dilated systolic function is normal. Trace of tricuspid regurgitation.

- seems to link together - most of us will have some degree of Tricspid valve regurgitation- used to be called a heart murmur- my husband has had this since he contracted diphtheria aged 9 - he’s now 88 & it’s not a been a problem throughout his life so not a perfect seal on the valve so some blood leaks back but not enough to worry about or affect systolic function so electrical pulses are getting through.

They are not concerned so I wouldn’t expect your GP to do much but you ask them what they make of it but hopefully you can understand a bit more now?

best wishes.

[Hidden in reply to CDreamer]

CD, Thank you so much for taking the time to comment. At least now I have some idea of the direction of travel and the possible pitfalls. That was just the sort of comment I was hoping for ... just something that would impact on my mindset and enable me to ask appropriate questions.

Now we have to watch JeanJeannies posts to see what she says about her Echo .... if anything. 😂😂😂😂

John

[Vince1001]

John,

This video may be of benefit...Making sense of your echo report by York Cardiology. Parts 1/2

facebook.com/yorkcardiologi...

Cheers!

Vince

[Hidden in reply to Vince1001]

Hiya Vince,

Thanks very much for that link. I'll have a look at it.

Hopefully, Jeanjeannie has seen your post and hopefully it will help her too.

John

[BobD Volunteer]

Basically your heart is a bit stiffer than it was John but still working from my understanding. For me the best bit is no increase in dilation of the aorta. That is good news.

[Hidden in reply to BobD]

Thanks Bob, looking at CD's comments thats probably about right - might change my user name to either 'stiffheart' or 'stuffedheart' 😂😂😂😂😂😂😂.

Maybe not the second choice ..... reminds me too much of life in the 1950's with ration books - my mother used to cook offal ........ she did stuffed hearts and I found them magnificent, just so tasty.

Cheers,

John

[Samazeuilh2]

Hi John, I’m not knowledgeable enough to be able to interpret these results; I recommend speaking to one of the cardiac nurses at BHF. They’ll be able to tell you, at least in general terms, what might be going on. The most significant item looks like number 1. There’s a description of left ventricular hypertrophy here:

mayoclinic.org/diseases-con...

[Hidden in reply to Samazeuilh2]

Hiya Samazeuilh2,

Thanks for that link. Having read CD's comments and looked at the Mayo Clinic commentary I can identify with many issues ....

sedentary lifestyle, booze, lack of exercise, poor quality sleep, diet, ongoing BP issues.

I hadn't thought of the BHF cardiac nurses, was certainly going to speak to my surgery pharmacist on the medication options.

I would love to exercise more but I hate gyms. Loathsome places. Love the outdoors, especially all the coastal walks here in Cornwall but I hate the cold. I've lived over half my life in Australia and so the thought of going for walks in this cold weather makes me perish. I just can't do it. Spring and summer - no problem. The ancients called this the dead season ..... not bloody wrong. Thats just how I feel. Hate the cold.

Anyway, thanks for the pointer.

John

[Auriculaire in reply to Hidden]

I expect our ancestors did as little as they could in cold weather- huddled round fires or under furs trying to keep warm. I doubt they went on many walks to get a bit of exercise! Know how you feel. We had a very hot summer here ( 4 official heatwaves) and the hot weather continued well into autumn - still biking in summer jackets at the tail end of Oct. Now the cold has set in and it's a horrible shock. Damp too so body aches up a lot. Stuff this keeping the heating at 19° . 19° is cold. I don't feel guilty about having it higher as our heating is done by a heat pump and we have solar panels which produce leccy that goes to EDF . You should be over the moon with your EF of 65.2% .

[Hidden in reply to Auriculaire]

Hi Auriculaire,

Thanks for that ........ glad you understand 🙂

Cardiac and cold is one thing .......... damp, moisture, barometric pressure and humidity is quite another especially in the context of aching joints. 🙁 Mercifully at the moment in Cornwall barometric pressure is a handsome 1012 mb and humidity 33% with frost forecast tonite.

Just been advised of an installation date of 16th January 2023 for our solar panels.😆

Thanks for your comforting words on my EF.

Stay well, stay safe.

John

[Goosebumps in reply to Hidden]

I know what you mean about the cold. Thermals are the only things that get me out of the door.

I’m sure it has been suggested before, but I got myself ( had to push) onto the NERS national exercise referral scheme after my stent. It’s twice a week at the leisure centre, good range of starter exercises and nice company. Walking is good but a few higher intensity moves is even better. And, it’s cheap and indoors……

What’s nice is that I have met people in a far worse condition to myself. Oops, that came out wrong. What I meant was, people struggling to breath or walk, it makes me realise how lucky I am. It’s good to be there and encourage them, so each session has a positive upside.

The instructor says moaning is not allowed, so I moan about the air conditioning, the weather, the music they are playing. I always throw some trivia in for the group to tussle with. The other week ABBA we’re playing so it was name the members of the group, first names of course. We couldn’t get one name, how daft!

Unfortunately the NERS only runs in Wales but I suspect there are similar schemes in your neck of the woods.

Sorry I can’t help with the echocardiogram question. My last one just told me I wasn’t pregnant.

[Samazeuilh2 in reply to Hidden]

As you know I’m in the Basildon heart hospital at the moment. Doctors told me that walking is *the* exercise for the heart. Get that woolly coat on…

[Singwell]

Had mine a couple of months ago. Happy to post comments for comparison if you'd like. Am 12 years your junior!

[Hidden in reply to Singwell]

Hiya Singwell,

Thanks very much for that offer. If you could post comments that would give me something to consider. Thanks for your offer. I must say I have a feeling I'm slipping and slurping into a different realm of the cardiac world.

John

[Singwell in reply to Hidden]

OK I've looked at my results from October 2022. Did you get a CONCLUSIONS section? I'd say this is important. My GP was very good (actually it was the Legendary Locum) and talked me through it all. My understanding is that trivial or trace regurgitation is nothing to worry about. I have some in the mitral valve but only 'trivial-. I have a 'mildly thickened Mitral valve but 'mobile leaflets'. I was given to understand therefore (since things are mobile) nothing to worry about. There's a good video on York Cardiologist about understanding your echocardiogram results Andy advice between now and talking with your GP is to hunker down with thar so you have am idea of what it all means.

I'd guess if interventions are recommended then you should be seeing your cardiologist. Don't want to say more as TBH I was just happy that the GPnsaid - it's all good news.

Hope your get some answers.

As to longevity - my Dad was fitted with a pacemaker in his early.80s and made it to 93. It wasn't the heart that took.him out, it was the vascular dementia

[Hidden in reply to Singwell]

Hiya Singwell,

Thanks for your time. In the main body of the report I got a SUMMARY at the end comprising a 7 point summary and 4 of those points refer to a dilation of various bits and bobs. 1 point relates to a coincidental discovery ! Then there is the first issue I mentioned (severe concentric LVH). The final point in the summary is my BP clocked after 30 mins lying on the couch in a very uncomfortable position for someone with so many arthritic issues in both shoulders. Clocked at 141/72. HR during this ordeal was 68 bpm. My normal resting BP at home is around 131/70 to 134/80 and my HR is usually in the range of 64 to 68 bpm.

Now here is the rub ......... I never asked for this Echo. Surgery rang me one day and asked when I was available. I asked why. Receptionist didn't know why. I feel real good with no symptoms of anything. Go figure !

I searched through stuff I have on a portable hard drive and found papers relating to a previous Echo in October 2020. The final comment in the covering letter was "I would also recommend a repeat echocardiograph in 2 years to reassess his aortic dimensions." So now we know where the push for a new Echo came from. I suspect this was driven by the Cardiography mob and not my Surgery. Incidentally my BP in October 2020 was clocked at 152/87 with a HR of 70 bpm. I am well known for being vulnerable to the " whitecoat" syndrome. 2 years ago my average home resting BP was 132/74 and HR 64 bpm. The Consultant Cardiologist who signed off on both reports (2020 and 2022) was the same guy.

Now that I have the benefit of a cross section of views from peeps who read my original post I shall prepare a list of questions for my GP and make an appointment with her with the view to getting a referral to the guy who signed off on these reports. I might also have a chat to our Surgery Pharmacist about medication options.

The last Cardiologist I saw was the one who diagnosed my AF in Jan 2010 at East Surrey Hospital, Reigate and I saw him several times in the first year of my AF. Nobody since because my AF became so well controlled.

So there we are Singwell .... thats my story in perspective. Thanks for your thoughts.

John

[Singwell in reply to Hidden]

Good to read you're getting more of a perspective. May force be with you for good strategies if needed and outcome to continue enjoying your clearly active QOL!

[Ppiman]

I can only go from the evidence and experience of two older friends with AF who have somewhat similar findings to your own, both of whom are well for their age. I would guess very many people in their late seventies and beyond would have a similar cardiogram and I bet your GP will say much the same.

Steve

[Hidden in reply to Ppiman]

Thanks Steve, you are probably right . As I said to CD the one thing that bugs me is as I am/can be asymptomatic with AF and as I feel so well can I be the same for any of this stuff and if so what risks are involved and whats the nature of the risks.

John

[Ppiman in reply to Hidden]

I did read that there's some evidence that the overall mortality for people with some of those things is reduced, but when I looked closer at the evidence, well - it's not all that clear since once we go beyond, say, 75, then age-related things come into play along with so many other confounding factors (not least obesity, high BP and diabetes for some) and, well, we all have to die of something.

Oh to be young again, I say!

Steve

[Hidden in reply to Ppiman]

I am young Steve, well brain anyway, the rest of it .... cardiac and joints are a bit clapped. I'm rather hoping that I have some of my paternal grandmothers genes ..... she drank alot of sherry and eventually snuffed it at 102. 😂😂😂😂😂

[Ppiman in reply to Hidden]

My wife's family sound similar to yours; my own - not so long lived but both life long smokers which I have never been so I hold out some hope!!

Steve

[SeanJax]

They monitor your aorta since it is growing in size and if it keeps growing it might cause dissection of the aorta. They thought since you are 78 you don’t need biannual echo surveillance. What a discrimination against elderly. Keep asking echo once a year. For now there is nothing to be worry about. When aorta grows beyond a size which is prone to dissection they have to intervene surgically with open heart surgery. At 78 open heart surgery is very high risks especially when they have to replace a portion of the aorta.

Other aspects of the echo is you have hypertrophic concentric of left ventricle which you tolerate well until now which explains the high blood pressure, please see with your cardiologist for the treatment. Some medication would relax the vessels downstream and allow the heart to stop working so hard would be beneficial, please ask your cardiologist or the ep.

The aortic valve sclerosis needs to be monitored and for now, nothing to worry about.

In a nutshell focus on your blood pressure. Hope it helps.

[Hidden in reply to SeanJax]

Thank you for your thoughts. I am the eternal optimist, however, I am equally very untrusting and so I now have a telephone appointment with my GP on Friday morning during which I intend to ask some fairly blunt questions. I am currently on BP medication which for the most part does the job. I have a tendency toward the "whitecoat" syndrome and so when in medical surroundings my BP tends to take a walk on the wild side. At home in a rest situation, laid back etc my resting BP is around 134/72.

I do not believe my GP has the experience to answer my questions other than in generalisations and so I'll either ask for a referal to a cardiologist or just pay for a private consultation for some advice on the way forward.

That said I am reducing my booze intake and am planning of some exercise.

Many thanks,

John

[BlueINR]

Here's what I read: the left ventricle is enlarged, some sclerosis of aortic valve which usually indicates narrowing, a small amount of fluid in pericardium that is not problematic. Ascending aorta is mildly dilated. If your afib is controlled and you're doing well, it seems good to me.

[Hidden in reply to BlueINR]

Thank you BlueINR ................ coupled with my very good EF of 65.2% is something to be cheerful about. As one AF'er said, I should be over the moon about that.

John