ECHO RESULTS

[rosita1960]

Hello, Can anyone shed some light on my latest echo results. I have had several done over the last 20 years at the cardiac section of my local hospital, which all seemed to be as ok as they could be. The latest one was done elsewhere so they didn't have anything to compare it with. It says; Normal left ventricular size with mild concentric hypertrophy, severly reduced LV systolic contraction secondary to severe hypokinesis of all segments with the exception of the basal to mid lateral wall which appears relatively preseved. Visually estimated ejection fraction 30%. Heart rate consistently greater then 100. Indeterminate diastolic function due to EA fusion. Following all normal:: mitral valve, left atrium, trileaflet aortic valve, aortic root, pulmonary valve, right ventricular size and systolic contraction, trcuspid valve, right atrium. IVC not dilated. No pericardial effusion.   CONCLUSION: Non dilated cardiomyopathy with severly reduced function.  Satisfactory valvular function.  Sinus tachycardia throughout study.(Probably nerves). How is non dilated different to dilated? Is this treatable?

[kenkeith]

Quote: "You say you had hypokinesis, does that mean you don't now or is it still there but your heart is functioning better?"

I don't have hypokensis currently, or if I do it is very slight.  My heart functions normally for the past 5 years.  I no longer take medication to increase the heart's contractility.

Yes, it is possible the valve insufficiency stressed the heart to work harder as less blood was being pumped into circulation with each heartbeat as some blood was lost to blood backflow of the mitral valve.  A harder working heart will enlarge and the enlargement can/will reduce the strength of the heart's pumping ability if not properly and effectively treated.

You won't experience any symptoms usually until the heart walls impair contraction to the extent the heart is only pumping less than (EF) 29% of the blood received with each heartbeat.  Some people experience symptoms at an EF below 29%  and some experience symptoms with a higher EF.  Some people compensate better than other individuals.

[rosita1960]

You say you had hypokinesis, does that mean you don't now or is it still there but your heart is functioning better?
My first echo showed mitral valve incompetance with an enlarged heart, so I'm thinking thats where the problem started. I've been on medication for the last 20 odd years and the valve no longer leaks and as the latest echo shows the heart is normal size. I've had several echos over the years at the same place and they were happy with the results, the last one was done elsewhere, so they had nothing to compare it to.  Could that be what this is related to? I haven't seen the other echo results so I'm unsure if I have had hypokinesis all this time if it's a new ailment. I don't feel unwell, no shortness of breath or chest pains.

[kenkeith]

Hypokinesis impairs heart contractions and sometimes the heart cells are not necrotic (akinesis) and can be revitalized with an adequate blood flow to deficit area.  About 5 years ago I had hypokinesis and an EF 13 to 29%.  With medication and a stent my heart is normal size and functioning well.

Your echo does not indicate any valve dysfunction only problem is the hypokinesis!?  Indeterminate regarding filling pressures so no conclusion there. Need clarification by your doctor what caused hypokinesis...it doesn't appear to be your valves.

[rosita1960]

Thanks, I understand a little more of what is going on now. Is non dilated cardiomyopathy worse than dilated. Is there any medication that will help my condition, I've been on ramipril for mitral valve incompetance for the past 20 years. I knew my heart was damaged due to it enlarging from the valve leaking, but I haven;t seen any of my other echo results so I don't know if I've had this conditon since that or whether it has developed over the last 20 years.

[kenkeith]

"Indeterminate diastolic function due to EA fusion",  LV filling pressures are determined mainly by filling and passive properties of the LV wall, and can/will reduce filling capactiy.

Concentric hypertrophy is characterized by thickening of the intraventricular septum (wall separating chambers) and the free wall of the left ventricle (this condition can/will reduce filling capacity). This hypertrophic process is initially adaptive, in that it enables the heart to maintain normal pump performance in the face of the increased afterload (constricted vessels) that is imposed by an elevated blood pressure. However, this hypertrophic process hypertrophic process leads to a series of maladaptive changes that occur in the extracellular matrix, as well as in the cardiac myocytes themselves (that explains the hypokinesis....hypokenises indicates heart cell damage of heart walls and this reduces the heart's ability to effectively contract resulting in the estimated EF 30%...normal is 50 to 70%.

Dilated cardiomyopathy: One of the best-recognized consequences of sustained hypertension is the development of dilated cardiomyopathy that is characterized by progressive dilation of the left ventricle and decreased systolic performance of the left ventricle. One of the hallmarks of dilated cardiomyopathy is the progressive thinning of the left ventricular wall, as well as an overall increase in left ventricular cavity dimensions.  You don't have that condition!




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[Nicolina87]

I know that dilated cardiomyopathy is characterized by the heart becoming weakened and enlarged, and it cannot pump blood efficiently ( which is show by your low EF). Do you have high blood pressure, diabetes, thyroid problems? Non dilated would mean it could be another form of myopathy such as restrictive, hypertrophic or viral.