Please advise, very scared. Re: Familial Cardiomyopathy, my lv size increased 2x

[EricV]

First off, I want acknowledge that I am able to appreciate the fact, respectfully, that compared to many my problems are nil (for now), so my hat is off to many here. That said, I am something of a "veteran" of heart disease in my own way, having seen my father through his CM, then transplant, then through his passing in '96. Given that he was diagnosed w/ CM (idiopathic hypertrophic, I believe it was) when he was 34 and his two uncles died in their early 30's of unspecifed heart issues (that was WW2 Europe, don't think they knew any more at that time) my cardiologist recommended I get a good workup annually, in case there's something hereditary/familial going on.

My Q is this, basically: how much variation across LV measurements is acceptable "variation?" My past 2 echos showed an increase in LV size, + 2 mm each time for a total of 4 mm. My concern is that this is the earliest sign of an emerging CM. More info...

I am now 40 (w/ a daughter, adding to my concern) and have not had any apparent issues. I have had high BP in the past (moderate, not very high) and also elevated cholesterol (total close to fine, but not a great ratio of good/bad) and very normal weight. Overall fit, good stamina. My doc advised me to be on BP and Statin drugs as pre-emptive therapy. My #'s have been great for years. Back to the annual work up: he's been doing the echo to measure my heart- primarily LV (filled) size which I understand to be a good early indicator of an emerging CM. Here's the trend that has me freaked:

1/06    LV   4.4 cm (normal range being 3.5 to 5.7)
1/07      LV   4.6 cm
11/07    LV   4.8 cm

This, to me, seems a disturbing trend, though I should acknowledge that in early '05 it was 4.5.

EF has been consistent at 60-65%...I hope that's good (my doc says it's fine.)

So, I can't help but wonder if there is some kind of "normal" variation among echo's- be it changes in the heart itself, or perhaps attributable to the different tests (i.e.they're shooting at a moving target, two different radiology techs, etc- those kinds of variables as well.)

I am trying to get ahead of myself here, but again I'm a bit freaked and talking to those who are not close to heart issues, well, it seems to fall on deaf ears. My doc will only say "well, it could be an early indicator, just too soon to tell, and at this point I am not overly concerned." I truly believe in this guy (his rep is stellar, and he really seems interested) but I can't gain any feel. I can also respect his need to not "go there" yet.

So, all I ask is for educated opinions. My most sincere thanks, I truly didn't mean to go this long on you guys.

Respectfully,

Eric

[EricV]

...in case it's relevant, as it pertains to possible variables that could possibly add to variation of measurements:

Was living very high stress in 06-07...divorce, and extremely high pressure corporate job w/ long hours. Not sure if this can cause heart remodeling.

Stress largely past- get on very well w/ ex and switched jobs to something much, much lower stress 2 months ago..I hope this helps my LV size. :)

Thanks all!!

[surfgirl709]

may I suggest doing a google on heart failure, there are many :chat: rooms for that topic........that way you can exchange information and get support from others.
In the mean time, it does seem to be trend that is going in the wrong direction.  

[surfgirl709]

I have had many doctors tell me that all the stress in the world will not cause heart failure, or an enlarged heart.  I tend to think that if the stress causes high blood pressure for a long time, this could cause strecthing of the heart muscle, but they disagree with me. One doctor actually said that if stress caused heart failure, all doctors  would be in chronic heart failure, and so would parents of teenage girls.   I just thought I would pass this on for what it's worth.  I know I have been at a time in life when I would have loved to have said to my boss, "See?  This job is killing me"  but that whine wouldn't work, I guess.  

[EricV]

Thanks surfgirl!

Yes, I agree that stress, in and of itself, does not cause enlarging. Now I have learned (in research and talking to docs) that high BP does cause it. It's like any other muscle that works harder for extended periods- they bulk up (think weight lifting.) So over the long haul, high BP does cause what's known as remodeling. Still, bottom line is that stress, in and of itself, does not. I really do appreciate your time and wish you well!