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atrial septal aneurysm/ LVEDd

My echocardiogram says that there is evidence of intra atrial septal aneurysm, and that if clinically indicated suggest TEE. It also says that the Left ventricular internal dimension is mildly enlarged (5.6) with normal systolic function and normal ejection fraction of 73 %. I did another echo with bubble study, and the technician said it was positive. i did not get the results of my second echo yet. i will be doing a TEE echo soon.

I'm not worried about my septal aneurysm/PFO as much as I am about LVEDd enlargement. what makes a LVEDd become enlarged?

Im 20 years old and asymptomatic.
8 Responses
367994 tn?1304953593
A TEE will provide a better view of any atrial septum defect and a better evaluation of any shunting (passage of blood from the left atrium to the right atrium).  I assume that is the reason for the TEE.

Your left ventricle is slightly high and that would account for the EF to be in the high normal range. When the left ventricle dilates the EF is increased, and this is normal compensation together with heart rate, and blood pressure variations maintain a balance of blood flow between the right and left side of the heart.  Your LV measurement is an estimation, and my records indicate normal dimension is 3.5 to 5.7 cm.  

There doesn't appear to be any medical problems of significance. Hope this helps, if you have any further questions you are welcome to followup.  Thanks for sharing and take care.
Avatar universal
Thank you for your response
Avatar universal
I'm afraid of my LVEDd getting larger over time. Its already 5.6 and im 20 years old. Is there any way to prevent it? and why should my LVD get larger? could my ASD or ASA cause it? or maybe other undiagnosed problems such as lung problems or sleep apnea? or Maybe im just being overly concerned about this ;)
367994 tn?1304953593
The left ventricle increases in size as a compensatory mechanism and an increase could be due to failing muscle of the left ventricle (your EF appears to be high normal) or there could be insufficient blood ejected (that could be the result if there is serious shunting of blood between chambers (noted to be positive) and insufficient blood ejected.

If there is high blood pressure, the heart works harder and increases in response. Greater demand for oxygen from a respiratory problem,(ventricles dilate in response to increased preload (higher volume of blood from the lungs).to maintain good cardiac output to meet system demand, etc.

Avatar universal
What are the treatment options for LVEDd enlargment?  and how long will it take the LVEDd to grow , like 1cm in size?

ty for responding to my questions.
367994 tn?1304953593
The underlying cause needs to be effectively treated if there is any serious medical problem that continues to enlarge your heart.  Your chamber size may never increase as the heart size is integrated well with the system as a whole and is pumping an adequate supply of blood.
Avatar universal
I just got my second echo. the 2nd echo was done a month lator from the first one. but theres new findings. first of all, my ejection fraction has dropped from 75% to 61.6% . the systolic function is normal in both echoes. I'm really concerned about the droping by 15. what does that indicate?

moreover, it shows mild bileaflet mitral valve prolapse with mild mitral regurigitation and minimal thickening of mitral valve. theres also mild triscuspid valve thickening.

atrial septum is redundant and hypermobile with positive bubble contrast study for R-L shunt with ASA and PFO or tiny ASD.

can u help me interpret the result.
367994 tn?1304953593
An atrial septal defect (hole) results in shunting of blood from the left atrium into the right atrium, and this happens as a result of the hole in the septum that divides the left and right side of the atria. A bubble contrast test gives a visual representation and degree of the anomaly.

For some insight,when the defects are large and the left-to-right atrial level shunting is significant, the right ventricle and right atrium enlarge significantly because of the increased volume. This happens as the pressure in the left atrium is higher than the left atrium.  When the volume of blood increases in the right atrium that causes more pressure in the right atrium that can/will be greater than the left and that results in right to left shunting.  R to L shunting can contaminate the mixture of oxygen rich blood with blood that hasn't gone through the lung filtering process.  If untreated the result can be less oxygen getting to heart cells with each heart beat and cause a medical problem with symptoms of shortnes of breath, chest pain, fatigue, etc.

A drop in EF to the normal range is not medically significant and should not be a cause of any concern. The EF is an estimate and with margin of error to consider.

ASA is atrial septum aneursym, PFO indicates a hole in the atrium that hasn't closed after birth, and ASD is an atrium septum defect that can cause structual problems of the heart when significant...tiny ASD and no valve disorders, etc. is the evaluation which is good.

"When shunting is significant, the right ventricle invariable enlarges depending on the degree of excess flow into the right side. If the defect is large and the shunt unrestricted, the pressures within the right heart will be identical to those in the left. In this case the right- sided pressures are referred to as "systemic". On occasion of long-standing high flow into the lungs, right-sided pressures may become "suprasystemic".

Hope this helps, and if you have any follow up questions you are welcome to ask.  Thanks for sharing and take care.
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