Diastolic Dysfunction Grade II etc.

[ellaboobella]

Hi everyone.  I had to make a change of cardiologists due to my annual appointment being pushed out by about 9 months, so I can't see the new cardiologist until mid October.  My EP, whom I had a follow up appt with, agreed to do my yearly echo since it was already many months late.  The findings have new things since the last echo, and one of them is the Grade II Diastolic Dysfunction.

I'm just trying to find out what's since my appt is so far away.  Have had horrid symptoms that are getting worse, so I'm curious if anyone is familiar and can shed some light.

Little background:

SVT, AFib, Atrial flutter---ablations for those July 2014.  Wearing an event monitor right now as the follow up at the one year mark.

TIA in 2013, possibly due to the arrhythmias.

MVP since childhood, palpitations since early teen.  Wasn't told my entire life what the racing heart issue was (SVT) so went many years allowing the palpitations to go on for up to an hour (no insurance most of my life).

Latest ultrasound showed some things I already knew about, and it also showed a few new things...

* Normal LV and RV size and systolic function
* Grade II diastolic dysfunction  (new)
* Normal ejection fraction 55-60% (told this is expected with DD)
* Mild biatrial enlargement  (new)
* Mild-Moderate MR, trace TR
* Trileaflet aortic valve with mild aortic regurgitation (new as of early this year)

Left Ventricle
LV chamber and wall dimensions are normal.  The estimated LV ejection fraction is 55-60% (normal).  Diastolic filling demonstrates pseudonormal pattern.

Right Ventricle
There is normal right ventricle size, wall dimension, and systolic function.

Right Atrium
Right atrium chamber is mildly dilated.

Left Atrium
Left atrium is mildly dilated

Aortic Valve
The aortic valve is mildly calcified.  There is mild aortic regurgitation.  There is no aortic valve stenosis.

Mitral Valve
The mitral valve is mildly thickened.  There is mild-moderate mitral regurgitation.  There is no mitral valve stenosis.

Tricuspid Valve
Tricuspid valve is structurally normal.  There is trace tricuspid regurgitation.  There is no tricuspid stenosis.

Pulmonary Valve
The pulmonary valve is structurally normal.  There is trivial pulmonic regurgitation  There is no pulmonic stenosis.

**last few items on the report I'm not listing because they're all normal**


Of the above, the items that are NOT new on this echo is the MVP with mild-moderate regurgitation, and mild aortic regurgitation.  All of the rest is new.  So I'm a little concerned about the calcification, thickening etc of the aortic and mitral valve since it showed up a little over a year later, as well as the atrial enlargement, and the pulmonary valve regurge (even though it's showing trivial, it's new).

Symptoms are terrible:  Shortness of breath on mild exertion, laying down, etc., fatigue, dizziness, weakness, and sometimes extreme swelling in lower legs... whether I'm standing or sitting.  Last night, for example, I was standing for a few minutes and my legs began to swell.  Standing is hard now, walking is really rough, and I have to sit on a chair and prop my elbow on the bathroom counter to blow dry my hair.  There are days when my muscles hurt like they don't have enough fuel, if that makes sense.. makes my arm hurt to brush my teeth.  Taking a shower is like climbing a mountain.

I have had sleep apnea testing/sleep study.. and all is normal.  They said I 'had events' but none were apnea.  They wouldn't really tell me anything but will forward the report to my doctor.

Tests for hypothyroidism came back normal.

I am going through perimenopause (hormone tests and symptoms confirmed).

I'm 53 yrs old and overweight.  I began gaining weight about 2 1/2 years ago because being active became impossible.   I don't even shop for groceries anymore... at all.  My life has pretty much come to a screeching halt.

I do have iron deficiency anemia, so that is adding to my fatigue, but even before that showed up on lab reports I had issues with terrible fatigue.

Left arm has been swelling for about 2 1/2 years now.  No one has found a cause.  Echo showed no veinous issues that could cause this.  Unknown if it's due to cardiac reasons.

Thanks in advance for any advice.

[ellaboobella]

Thank you for responding...but you're not talking too much about you, I promise!  This info helps, and hey... when we deal with this stuff we need to talk about it.  No worries there at all.  I appreciate your opening up about your experiences.  

the edema can be mild at times, or absolutely awful.  I have a degree of that going on pretty much all of the time.  When I stand for ANY length of time... within a couple of minutes I call feel swelling from my knees down, and I can see it too.  If I ride in the car for more than about 10 minutes I get severe swelling that sort of deforms my ankles and feet.

My doctors and pharmacist says what I'm taking shouldn't be doing any of this.

Meds:

Eliquis
Famotidine  (H2 histamine blocker)
Dexilant (Proton Pump Inhibitor)
Claritin on occasion if seasonal allergies are bothering me.

I've not had an angiogram.  And the only time I had issues with high BP was when I was dealing with AFib, SVT, and Atrial Flutter.  My BP would spike, then go back down.  My HR, prior to my ablation last year, was ridiculously low, and I'm not at all fit and haven't been since all the fatigue, etc. has come on.

Since my ablation last year.. my HR has actually been higher.  I read this was normal after an ablation.  It would hover around 90+ at times, when normally over the last few years my HR would be around 50-something, with dips into the high 40's.  Currently it can be as high as the 90's, or right at normal around 60.  These are all resting HRs.

It's interesting that you mention about having to rest when you're blowdrying your hair, etc.  I have to do that too!  In fact, I now have to sit in a chair to blow dry my hair.. and prop my elbow on the edge of the counter because I can't hold the blowdryer up but for a few seconds.  Brushing teeth---my arms ache horribly!

I'm not on any statins, though.  Be careful with that.. it can cause myositis, which is NOT good because that's when your muscles waste.. including heart.  My Aldolase shot up horribly a few months back, then it went back to normal.  I've yet to understand WHY that happened, but the doctor who did the Anti-JO test to confirm myositis (came out negative) was relieved that I wasn't dealing with that.  It's bad news.  So if you take a statin (known for causing this!)... get your doctor to check your aldolase levels at least.

I'm sorry you're dealing with HF and all those symptoms. :(  Unlike your HF, the issue I'm dealing with is Diastolic Dysfunction...where your EF is normal (called pseudo-normal).  It's an issue with FILLING, rather than pumping.  This is found to be just as risky as systolic HF, but if a doctor isn't LOOKING for it, then it can be missed.  I don't know if the DD is 'new' to my situation, or if they missed it in past ECGs.

This stuff runs in my family BIG TIME.  My mom and oldest sister both passed away from HF.  My mom passed at 62, and my sister about the same age.  I was born very late in my mom's life, so my mom was old enough to be my grandma, and my sister was old enough to be my mom.  But the age that they passed really wasn't very old, all things given.

What's really bothering me is the indifference many doctors in my area have.  I have to drag information out of them, and even then they really don't discuss the situation with me.  For example, my labs showed that I have non-alcoholic fatty liver disease (NASH), and my GI doctor kept going back and forth as to if he was going to do a biopsy to confirm.  He decided he would, then he just dropped the ball.  Several calls to the office and absolutely NO answer to my question as to if this will be done or not.  I just gave up calling.  While this is out of the scope of heart issues, I mention it as a representation of what medical care is like where I live.

Another thing I didn't mention is that my left arm has been swelling.  It started about 2012 and was ever so slight then.  Now.. it swells enough that people notice.  No one has addressed this either.

[tacolino]

Hi there. Wondering exactly what meds you take? Maybe sides are part of the problem? Did you have an angiogram at any stage?
I had Serious hypertension for a time, it caused heart failure and my ef was 15%. With meds its back up to 45%. But I cant believe the description of the fatigue and muscle ache symptoms you talk about. You just have 100% written exactly how i feel too!. Apart from swelling in legs its identical. I had put mine down to meds side effects, and guessed it was statins, but just a guess.
I am 18 months like this and never has anyone here described it so exactly. I have had lots of tests for adrenal function & hormone issues. The Professor i attend is still considering Conns, but we still have no confirmation of this yet.  I have to stop when chewing food, brushing my teeth and when drying my hair I have to stop every minute with the ache in my arm muscles. One of my tablets is Spironaldactone. You can look up the sides for this one!!
I am male 51 years, no previous before this started. I am talking too much about me, but hope its some way helpful??