Assistance with Echocardiogram Results

[broncoman96]

A little background. I am 38yr, non-smoker, non-drinker, caucasian male. For the last 10 years I have been on BP medicine, as my blood pressure untreated was around 145/95 on a normal basis. While on BP medicine it's normally around 130/85. I play squash about 2-3 times per week for the last 6-8 years, I am 6 foot 1 and weigh about 255lbs. So yes, I am very active, however I am also a big boy, I would certainly say more muscle than fat, however I do have a bit of a stomach since I like to eat things that are not great for me, more often than I should.

Over the past few months I was experiencing chest pain and general discomfort in my mid chest area with not real explanation. I went to my local Cardiologist and as expected they did an EKG and said I had not issues and it was likely a pulled muscle. Just to be sure, the wanted to schedule me for a stress echo, just to make sure. A few months later I go in for my stress echo, by this point the chest pain has gone away, i spend 20 minutes on the treadmill and get my HR up to 175 without issue. The cardiologist says "you passed, everything looks good except..." I was like seriously....  except, my papillary muscle looked enlarged, I had LVH and also I had a fairly high Ejection Fraction EF: 75%. The doctor said this is likely explained by being an athlete. As I mentioned above, I am certainly active, however I would by no means say I am an athlete. They referred me to have a CMRI, The doctor came back again and was totally dismissive and I just don't feel confident in that dismissal, as I have now done research on the subject and some of my results are out of range. Also he said, that was ok, since I have a high BMI and my heart is just going to be larger than someone who is smaller and it's all relative... which on the surface makes sense.

2D Mmode Results
IVSd: 1.2cm
LVIDd: 4.8cm
LVIDs: 2.6cm
LVPWd:1.2cm
LVPWs: 2.1cm --- this is one results I have a challenge with, as it seems very high
Fraction Shortening: 45.3% --- again, a bit on the high side, concerning?
LVEDV: 107.1ml
LVESV: 25.1 ml
Ejection Fraction: 74% --- again within high range, however seems very high for not real reason
LA Diameter: 4.1cm -- just outside of normal range. concerning?

Time Measurements
MV Dec Time: 0.19 sec

Doppler
MV E max vel: 99.0 cm/sec
MV A max vel: 58.8 cm/sec
MV E/A: 1.7
Ao V2 max: 186.0cm/sec
Ao max PG: 13.8 mmHg

I have more results, let me know if you would like to know what they are.

General Findings
Left Ventricle is normal in size
Wall Thickness at upper limits of normal range, however large BMI
The transmitral spectral Doppler flow pattern is normal for age, Left Ventrical systolic function is normal

Right Ventricle is normal in size and function

The left atrial size is normal, right atrial size is normal

The mitral valve is normal in structure and function

The Tricuspid Valve is normal in structure and function

The aortic valve is normal in structure and function

Pulmonic Valve is normal in structure and function

Pericardium/Pleural appears normal

A two-dimensional transthoracic echocardiogram with m-mode and doppler was performed, normal transthoracic echocardiogram

I am concerned with wall thickness on the systole side, and also with the high EF, as just two years ago it was 63% and I am not sure why it's climbing for no real reason.

Any help and thoughts are much appreciated.

[tacolino]

Hi there. All your test results above look good.
Valves all fine.
Ventricles fine
Structure all good too.
You had a cardiac MRI (A pretty intensive heart test which was normal)
You had an echo too. It was a TOEE test which is invasive and more advanced than a standard echo. This result was great too.

Yes your EF at 75% is upper end, but given your physique and training you do, thats pretty normal.

Its time to trust your doctor, he is the medical expert with all your results and history. Looking on from the outside all looks ok to me. Im not a doctor, but you need to listen to yours!

[achillea]

When we ask a doctor's opinion, we have two choices. One is based on accepting the idea that the doc went to med school, that med school is a real thing where students learn difficult stuff and come out with knowledge and the ability to treat illnesses.

The other choice is that medical school is a fake and that doctors don't learn anything that the average joe doesn't already know.

I guess it's up to patients to decide which is the most rational choice, but personally, I'd accept the doctor's advice.

[erijon]

Your numbers and results look normal. I would trust the doctor.