British Heart Foundation
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Echo results

Can anyone explain the following in very simple layman’s language:

At least moderately impaired LV systolic function. Apical septum, apical cap &apical lateral walls appeared akinetic & aneurysmal. Lateral inferior & anterior walls appear hypokinetic.

Also, does the term “at least moderately impaired” mean that there’s the possibly that LV systolic function could be more than moderately impaired.

What exactly is the systolic function, what does it do/not do.

Thanks for your help

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best I can say is type in 'systolic definition' in google

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Thank you I tend to avoid Google as the results are not always correct x

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I find definition at not to bad and systolic is used on blood pressure and heart failure I have LV systolic function, I believe it means when the heart pumps, if you check BHF site for blood pressure it will tell you two figures the top one is when the heart is pumping and the lower is when the heart is resting (top one being systolic)

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Thanks Andrew. Thanks for your reply, I'm kinda of aware the top is systolic & bottom is diastolic. What I don't really understand is what each one represents

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left ventricul systolic dysfunction is where the main chamber of the heart (the pulse) is not pumping out quite as it should. it therefore means blood is not getting sent out of the heart as it should which has a knock on affect in the rest of the body. if you haven't had one already they may want an mri scan to take a closer look.

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Thank you, MRI is not an option due to ICD being fitted. I do have some other questions to ask later if thats OK?

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Re diastolic/ systolic:

With every heart beat the left ventricle first relaxes to fill with blood, and then contracts to pump the blood out to the rest of the body.

The relaxation phase is called 'diastole'. Sometimes the left ventricle is stiff and doesn't relax enough. This is called diastolic dysfunction, and if it's bad enough to cause symptoms, it's known as diastolic heart failure ( or heart failure with preserved ejection fraction).

The contraction phase is called 'systole'. The left ventricle normally pushes out 50-65% of its contents each heartbeat ( i.e. a normal Ejection Fraction of 50-65%). If it's less than this it's called systolic dysfunction. This is measured normally by the EF and sometimes characterised more broadly as mild / moderate / severe.

Heart failure is also graded by symptoms, known as the New York Heart Failure classes, ranging from Class I ( no symptoms) to Class IV. Treatment aims to improve function, prognosis and symptoms, and does this very well!

As Andrew says, blood pressure readings record the BP during the 2 phases, systolic and diastolic.

Hope this makes it a bit clearer!

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Thank you, this it very informative. Its my husbands echo report which I'm trying to make sense of. He does have HF & his EF was 30 a couple of years ago down from 35 in 2012 when he had his ICD fitted. His cardiologist won't give him another echo, which I find a bit odd seeing as the last one showed a small reduction! Additionally, his BP was frequently in the low 80s over low 50s they've reduced one of his tablets & his BP is now usually low 100s over low 70s, so definitely an improvement.

Any ideas what "Apical septum, apical cap & apical lateral walls appeared akinetic & aneurysmal. Lateral inferior & anterior walls appear hypokinesia" means?

Thank you for your help.

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When heart failure is due to a heart attack it's common for the areas of the heart affected by the heart attack to be hypokinetic ( ie not contracting very well) or akinetic ( doesn't contract - normally because it's scar tissue). So your husband's report details which areas of the heart are causing the problem - basically part of the base and side. Aneurysmal means the heart wall is thinner at that point and bulges a bit - it's very common with scar tissue.

Basically these anatomic details don't really matter - it's the EF and above all the symptoms. I do sympathise, I often found myself worrying over obscure bits of information in the reports which weren't actually that important but sounded as if they might be!

In the NHS as a general rule they will only do tests like echos if the result might change treatment, not just to get more information. Since your husband has been diagnosed and had an ICD he will be on standard heart failure treatment and changes will be based on his symptoms - a lower EF wouldn't affect his treatment.

Is he on entresto?

All the best

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Thank you that is so informative. No Kevin isn't on Entresto, is that a beta blocker? Unfortunately, when Kevin had his HA 20 years ago he had a bad reaction to beta blockers so had to come off them. HF nurse wanted to try again just recently but his HR was too low. Also, in the 2016 they put him on spironolactone, he was on it for 3 months but his potassium went too high so he was immediately taken off it. Cardiologist really wants him on this tablet so in Jan they started him off on 1/2 tablet with regular blood tests. Up to last week his potassium was 4.7 but its now 4.9. Hes got another month on 1/2 tablet then they want to increase it to 1 tablet. I know 5.2 is considered high & 4.9 isn't far off that so theres a high chance he may come off it. His last Echo a couple of years ago was down from 35 to 30, I would have thought they would want to keep an eye on it, especially as they don't seem to be able to optimise his medication! HF nurse wanted him to have another echo but cardiologist said no. I don't understand why some people get them every year, any ideas? Xx

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