Impaired LV relaxation on echo - no known cause

[Jason216]

Up until a couple of days ago I was under the impression my heart tests were all normal, but after some investigating, (on my own), my echo was NOT normal. I was diagnosed with POTS in December, and despite the IMPAIRED LV RELAXATION indication on my echo, the cardio told me to massively increase my salt and water intake. I don't think so. He never even mentioned this finding to me, which seems unethical and incompetent.

I am a 42 y/o female with a BMI of 20. Never smoked, drank socially when young, but haven't really touched alcohol in years, never smoked and never illegal drugs. Up until this past year I  NEVER had an issue with blood pressure being high - it was always borderline low. Now I deal with fluctuating pressures, but it still averages out at about 100 over 70. Outside of the POTS (tachy when standing, fatigue) and a palpitation issue on and off for 15 years, I have no dyspnea or swelling or coughing whatsoever. had a normal stress test five years ago (a long time), and the cardiologist told me then I was out of shape, despite being slim (need to exercise, which I'm now working on).

what on earth would cause this and what are my options as a POTS patient - that is if i have POTS at all, maybe it's just the diastolic dysfunction).

thanks.

[ayl291]

I think it's prob the diastolic dysfuntion leading to pots...

Have you had a cardiac mri?

[Jason216]

Thanks for answering. I suspected that myself. I keep reading that diastolic dysfunction grade 1 doesn't cause any symptoms though. I guess that's not true. No i haven't had a cardiac mri, is that very invasive?

[Jason216]

The question remains, what caused the diastolic dysfunction in the first place? I fit none of the criteria.

[ayl291]

You must have ventricular hypertrophy.  So you not able to fill your heart enough.  You could also have some scarring.  

Its an mri so not invasive at all.

[Jason216]

I must have vh, that's pretty strong wording.

[Jason216]

I think that would have shown up on the echo, ecgs, chest x ray. No scarring or wall thickening.

[ayl291]

Ecgs are only really good for arrythmia or full infarct tbh.  They miss alot.  Xray is useless in terms of cardiac function.  Echo is way to user dependent and has noise.  We already know you have dd... so why is the question and how to prevent it getting worse...

I 100% think you need a Cmr (cardiac mri)

[Jason216]

I understand that, I was responding to your suggestion about ventricular hypertrophy. The echo said all walls and valves normal size. I will look into the cardiac mri.

[ayl291]

Good luck!!

[Jason216]

I forgot to mention I am ana positive (low titre), but haven't had it checked in a while.