Hello, I’m quite new to this game, having been diagnosed with AF in November. I was referred for an echo because my bnp level was slightly elevated and I can see the following results on my NHS app, but I can’t get to see the doctor for a week.
Can anyone help with understanding this please?
“1. Normal LV size with normal bi-ventricular systolic function. LVEF= 55%.
2. Mild mitral regurgitation.
3. Mildly dilated prox. ascending aorta with trivial aortic regurgitation.
Very grateful for any understanding of this. I’m a 68 yr old female.
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Enjoy the rest of your life Nothing there to be too worried about. Most people your age have some minor leakage from valves. Heart failure starts to be a possibility below 50 ejection franction so 55 is OK.
These sorts of results are quite subjective and operator dependent so another may list mild as either trace or moderate depending on which way.
Same here. I have mild leakage too. That was in 2020. I'm to have an echocardiagram following my appointment end of last October. And the cardiologist I saw asked if wanted an ablation. I said I'd do some research. Apart from my age 80 years 6.months my research led me to a definite no to ablation. How do I find out where I am on waiting list for echo?
Thanks Jean. Was hoping to speak to a friend on group walk yesterday as she had experience of finding out about waiting lists but she had urgent dental appointment!
My wonderful GP saw that my report had come in today and has just rung me to tell me that there were no signs of heart failure or disease and that 2 slightly leaky valves were of no clinical significance- so your advice was spot on! She knows that I’m a witterer though, and to completely cover all bases, she is asking a cardiologist whether, with my “trivial and mild” symptoms and AF, they think anything more needs to be done. Thank you again. It is so helpful to be a member of this excellent group! ❤️
A lot of the luckier AF patients have first echo results similar to yours, including myself. But I did request a second echo after 2 years to check that my results were still in the "no action required" category.
Yes I agree, trends are v relevant. I keep a note of all annual blood and other test results so I have some back up for any necessary discussions with medics.
Perhaps, but it would no doubt depend on your unique medical circumstances re AF and symptoms, plus the recommendations of your medical team. My preference would be for perhaps an 18 month interval in my circumstances. However, I have a light AF burden, and GP contact is a struggle. In the end the interval between my 2 echocardiograms was not 2 years, but 21 months, so not far off my aim.
As I don't have a medical team or Cardiologist or EP, it would usually be a change of symptoms that would encourage my GP to agree to another echo. As it happens, no such change in symptoms occurred in my case, so I deviously but very appropriately managed to initiate a second echo by requesting that my previously mentioned but not measured ASA (atrial septal aneurysm) should be finally assessed for its size and motion and stroke risks.
Your 12 month interval belongs to a world I don't inhabit at the moment.
Hi Bob, I'm in South Africa where we have Medical Aid Societies to which we pay monthly subs. which cover certain private procedures and hospitalisation. Although I only have asymptomatic PAF, one of the benefits from my Medical plan (I'm registered for AF which falls under International Disease Classification 1489), one of my benefits is: Cardiac examination Plus Doppler colour mapping, Cardiac examination (Mmode), Cardiac examination 2 Dimensional. Plus ECG. I'm allowed those examinations twice a year, but I only go once. I've been going to the for 8 years now, and my Cardio has all the equipment in his rooms. I can see him in between visits if needs be, but so far, I have not had to. I see my GP every six months to check mt BP and Asthma. It's just that I can go twice a year if I wish, that's not tailored to me put comes with my plan, I don't have to go if I don't want to, but some doctor who formulated the plan thought that twice yearly for AF was the way to go !consequently I wondered if every two years was too little !
Yes, your circumstances belong to a "different" world. Of course I would like the monitoring available to you in S Africa, but I have no private insurance and rely on the free NHS. And our NHS has just been through a period of deliberate neglect, so it's on it's knees at the moment. I can only hope the promise from our new NHS management of new "diagnostic centres" will provide wider availability of the kind of tests you receive.
PS. And presumably you have to "suffer" all that hot weather as well!🤔😄
The hot weather is a trial,😆 but we do have things like airconditioning and swimming pools. I'm not far from the Natal coast so we have high humidity and I have just purchased a dehumidifier for the house - I have had it running for a day and a half and it has pulled 48 litres of water from the air - I'm surprised I'm not covered in green mould considering I spent the first 23 years of my life (I married a SA resident) in England.! I had assumed you are Australian and 'Ossie' was just a corruption of 'Aussie' and used to hot weather. We do have public health here, but like the NHS it's overloaded, hence those who can belong to MA schemes. The big difference is , public health is funded out of general tax, not a special tax, and the only doctors and dentists who work for the government are those employed by the public hospitals and clinics - all the rest are private, as are most hospitals, pathologists, radiologists etc,etc. The Communistic Health Secretary is trying to change things, so all are equal, but he's got a battle on his hands as not only is the Government the biggest employer, and employees are members of a Govt. MA. - most of the doctors will flee the country !!
Sounds like your health system could be a hangover from apartheid days? As for "communists", Senator Joseph McCarthy will sort them out for you!🤔
As for me, I am indeed an Australian familiar with living in uncomfortable hot humid windy weather in unsuitable housing for 23 years in Sydney. But I have lived in London UK now for over 50 years and still struggle during the increasingly frequent hot humid days.
Seems that wherever I go the weather is always there!🤔
No doubt the system started in Apartheid days, but it's a good one. There are more Black people who are members of MA schemes than anyone else, and the Black Govt, who has been in power for the last 30 years has up until this current Minister of Health nevertried to change it. When I still lived in the UK, the NHS seemed fine - I remember my Mum having her gall bladder removed at Windsor hospital (our nearest one) and telling us how wonderful the surgeon was. I'm not quite sure how it worked prior to the NHS because as a toddler(I was born in1943) I stuck my finger in the cogs of a mangle and the surgeon at that same hospital stiched this tiny finger tip back. You would never know today that it was reattached. I don't think McCarthy, if he was still around, would be much help. SA has the largest Cabinet (many Communists in it) in the world. The EFF which is the true Marxist party is not even part of the new Government of National Unity, more Black votes went to the DA the traditionally White Party which previously was the official opposition but is now part of government.😀
in 2010, 70% of the public was satisfied with the NHS, which was a record high at the time. However, satisfaction with the NHS has since declined to record lows:
2011: Satisfaction fell 12 percentage points to 58%
2022: Satisfaction was at 29%, the lowest level ever recorded
March 2024: Satisfaction was at 24%, a 5 percentage point drop from the previous year
... and 2010 was the start of 14 years of NHS neglect, underfunding and "reorganisations" favouring privatisation, all under the control of the Conservatives. A policy choice that has turned out about as well as the state of our rivers and beaches under privatised water companies. Another wonderful legacy of the Thatcher years.
I'm from Berkshire and I cannot understand half of the regional British accents, so a Saffa one should be a piece of cake! - but I don't think the weather would be an inducement! My DIL's sister is a doctor, she married an Australian lecturer and can just about manage the weather in Sydney😆
My decision, appreciated by my GP as she has no hesitation in accepting that she is not a cardiologist and appreciates his reports on patients. That apart, my Medical Aid Society to which I pay high subscription fees, allows me to have two such visits per annum (obviously the these benefits are decided by a panel of professionals) - I just use one, it puts my over anxious mind at rest and my GP is happy to know what is happening with her patient's heart. Last visit in Sept to Cardio, he said 'No Change' Basically my heart is fine - I just need it in writing every year !😆
You have normal LV function. The slight regurgitation, on your MV is OK, they will occasionally recheck it's not a major issue.Same with mildly dilated Aorta with trivia Aortic regurgitation. I'm sure they will recheck in a few years time, also if significant a Stethoscope will pick it up.
How do I know? I'm was a quilified NHS Echocardiographer, but now just work with just Pacing /Devices.
The Echo machines pick up everything, especially the kit now, they are incredible machines.
Also a good Echocardiographer can pick up Trucuspid Regurgitation on nearly everyone.
I was always surprised when I wrote a report when no one had any Valve Regurgitation.
Thank you so much for that reply- really helpful. After only a few months of this, it’s still very easy to fly into panic mode, so thank you for the explanation and reassurance.
This is excellent, great comments. I have just taken a look at my own echo results from 18 months ago and the notes show:-
‘Mild to moderate AR; mild TR. ‘
Is AR aortic regurgitation and TR tricuspid regurgitation?
‘Normal LV cavity size, normal wall thickness, good LV systolic function with 60-65% EF. Normal RV size, good long axis function, good radial systolic function ‘
These are reassuring comments I think , the EF value especially heartening (sorry!)
‘Estimated PASP 41mmHg +RAP. Intermediate echo probability of pulmonary hypertension. Non-dilated IVC with >50% inspiratory collapse’
Absolutely no idea of that all means.
‘Mild bi-lateral dilation. Thin inter-atrial septum. No obvious shunt/PFO detected from images obtained but cannot confirm by TTE alone’.
Again, lacking knowledge to fully understand these comments between the echocardiographer and the cardiologist. Am awaiting appointment with cardiologist to review, but any interpretive comments re above would be much appreciated.
That appears to be fine.. Don't worry about the AR and TR, they will probably do another one in 3-5yrs time. Your Cardiologist will be able to give you the full low down. Your GP can also hear via their stethoscope if anything significant changes. We tell folk all the results are like a jigsaw, you need all the results to make a complete picture. Your Cardiologist will give you the conclusion.
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