Echocardiogram results

[july48]

I can find lots of reasons for a dilated left atria but is there any other reason both atria would be dilated except for amyloidosis?  Both ventricles are normal size.

[july48]

Thank you, I should have provided more complete information regarding my question about bi atrial dilation being caused by amyloidosis. I understand hypertension can cause LA dilation but I did not think it would cause RA dilation without some changes to the RV being evident.  No matter what the cause, do atria ever go back to a normal size if the underlying problem is a fixable one?

I have had multiple several echocardiograms (the three most recent are 2008, 2010, and 1/2012) prior to the current one, 4/2013.  The 2013 echo was done in a different place so there was no comparison to reports of my prior echo's. I have a 10 year history of hypertension which is treated with medications and I was diagnosed with MGUS three years ago (found by accident but has been stable). The 2010 echo is where abnormal changes began, 2008 was normal.

2013 atria: RA mildly dilated and LA severely dilated (diameter = 4.2cm, volume is 97ml, indexed volume 1.9 cm/m2).  2012 RA normal and LA borderline normal (volume not measured but diameter was 4.0cm).  2010 RA and LA normal (left diameter 3.7 cm)

2013 LV size end systole = 2.8 cm and 2012 LVIDs = 2.97cm, 2010 = 3.20cm.  

2013 LV size end diastole = 4.3 cm and 2012 LVIDd = 5.71cm, 2010 = 5.45cm

2013 LV post wall thick-diastole =1.1cm, 2012 LVPWd = 0.91cm, 2010 = 1.0cm

2013 IV septal wall thick-diastole = 1.0cm, 2012 IVSd = 0.91cm, 2010 = 0.80cm

2013 LV size, systolic function, and wall thickness are normal.  LV ejection fraction = 63%. Noted LV diastolic dysfunction An EKG indicated a left anterior fasicular block (present since 2009) and first degree heart block (new).  2012 LV ejection fraction = 70% with mildly reduced LV compliance.  2010 ejection fraction = 71.6% with mildly reduced LV compliance.

2013 RV size and systolic function are normal. 2012 RV size and function is normal.  2010 RV cavity size is normal.

2013 aortic root dia = 2.9cm, 2012 = 2.29cm, 2010 =1.95cm

2013 aortic cup separation = 1.7 cm, not reported for 2012 and 2010

2013 inferior vena cava is small and collapses with inspiration, not reported for 2012 and 2010

2013 aortic valve opens well but mild sclerosis is present but no stenosis.  2012 & 2010 aortic valve is structurally normal with no stenosis or significant insufficiency.  

2013 mitral valve leaflets are mildly thickened with decrease in opening excursion and mild annular calcification but no evidence of valve prolapse.  2012 clinically insignificant trace mitral insufficiency. 2010 structurally normal with no stenosis and no significant insufficiency.  

2013 tricuspid valve is structurally normal. 2012 & 2010 structurally normal with no evidence of stenosis and no significant insufficiency.  

2013 pulmonic valve not well visualized. 2012 & 2010  structurally normal with no evidence of stenosis and no significant insufficiency.  2010 mild tricuspid regurgitation that is not clinically significant.

2013 pericardium has a trivial amount of pericardial fluid. 2012 no effusion seen.  2010 small non-hemodynamically significant pericardial effusion that is within normal limits.

2013 & 2012 pulmonary pressures were not mentioned.  2010 pulmonary pressures  were mildly elevated between 35-45 mm HG (normal <35). This estimate based on assumption that RA pressure 5mm HG but since vena cava not visualized, true PA pressure could be plus or minus 5 mm HG

[CCFHeartMD11]

There are many reasons for enlargement of the atria. Amyloidosis can do it, but also causes significant thickening of the ventricles and impaired relaxation. Leaky or tight mitral and tricuspid valves can cause enlargement of the atria. Stiff ventricles from long-standing hypertension can cause the atria to enlarge.

It really depends on what else your echo shows. If the atria are enlarged in isolation, it is unlikely to be amyoid or valve related.