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Chest discomfort, mild left atrial dilation, low normal EF, possibly benign?

Hi all -- I'm a 30 year old female who has had off and on chronic chest pain/discomfort since the age of 13. Was diagnosed with "precordial catch" as an adolescent by my pediatrician. Mostly subsided as I grew but in the past 5 years, has grown worse and become debilitating at times when coupled with shortness of breath (which I can never tell is just the result of anxiety when I get chest pains?). I'm 5'7" and weight has fluctuated 170-210 lbs for the past few years (I know this is overweight). Former social smoker but never regular user of tobacco. High stress persona life/career + overindulgence of wine considerably. Off and on borderline hypertension + extreme white coat syndrome so it's always hard to tell. I'm currently working on lifestyle changes -- monitoring my BP at home, decrease stress, sodium, alcohol, exercise etc.

First time visiting a cardiologist recently to rule out anything heart-related and to confirm a likely diagnosis of costochondritis as some of the symptoms appear to be musculoskeletal in nature (a heating pad helps, increases with stress, I have generalized anxiety disorder and am just an overall anxious person). Cardiologist did an EKG, normal, and ordered an exercise stress test with echo cardiogram & doppler.

I had good functional capacity, finished after 12.5 minutes, 14.5 METS (I'm a former athlete who always at least attempts to do some rigorous cardiovascular activity periodically). Negative stress test for ischemia or anything else and normal blood pressure and heart rate response. Doctor seemed totally fine with my results.

When I saw the report, however, several items concerned me: mild left atrial dilation (3.9 cm) and low-normal Ejection Fraction (50%). I also had mild regurgitation at rest for all valves besides aortic but am not concerned about this as I know this is common. Everything else was normal. Doctor did not seem concerned or interested in any follow up until I told him I was considering pregnancy within the next year. He then order the BNP blood test as he said pregnancy is like one long stress test on the body. Currently waiting on those results. A cardiac MRI would be next course according to him.

My question is: has anyone else ever had an idiopathic or benign low-normal EF and/or mild left atrial dilation? If this is caused by hypertension, which I read it is, if I lower my BP can I reverse course? I'm completely committed to healthy lifestyle changes but am just really concerned I've already done permanent damage. Any comments much appreciated.
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Avatar universal
How hypertensive are you? I mean if your afterload is high on your lv it will eventually dilate or hypertrophy... that's caused by high bp... but again... how high and why is it high.
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