2D echocardiogram results

[charger69]

Does someone know what this means?? I think it is something bad when it says “severely “.
Is “grossly normal”, good or bad??

EXAM/PROCEDURE
Complete 2D/M-mode, color Doppler, and spectral Doppler echocardiogram
performed. The study was technically adequate. Prior exam was performed on
3/3/20.

Interpretation Summary
Normal sinus rhythm. Since 3/3/20 LV size remains normal. Ejection fraction
has improved from 46 to 54%. Left atrium remains severely dilated. Mitral
regurgitation remains physiologic. Aortic regurgitation remains trace.
Estimated PA pressure remains approximately 20mmHg. No other significant
changes are noted.

LEFT VENTRICLE
The left ventricle is normal in size.LVED Volume indexed = 60.3 ml/m^2.
There is increased left ventricular mass with increased relative wall
thickness consistent with severe concentric hypertrophy. LV mass index =
177.3 grams/m^2. Relative wall thickness= 0.46 (nl <0.42). The left
ventricular wall motion is normal.The ejection fraction = 54.3 % by biplane
Method of Discs.

DIASTOLOGY/HEMODYNAMICS
Pulmonary artery pressure is 21/7mmHg. Right atrial pressure is estimated
as 3mmHg. The IVC measures 2.0 cm. Mean pulmonary artery pressure is
estimated at 16.1 mmHg. (nl <25mmHg). Cardiac output is 6.3 l/min (nl 4-
7l/min). Cardiac index is 2.9 l/min/m^2 (nl 2.5-4.5l/min/m2).

RIGHT VENTRICLE
RVDd1 = 4.5 cm. RVDd2 = 3.3 cm. The right ventricle is dilated at the base
only which may be reflect RA enlargement/TV annulus dilatation. The right
ventricular ejection fraction is normal.

ATRIA
The left atrium is severely dilated. Left atrial volume (bi-plane) = 56.5
ml/m2 (nl < 35ml/m2). The right atrium is mildly dilated. The interatrial
septum is intact with no evidence for an atrial septal defect.

MITRAL VALVE
There is mild mitral annular calcification. The mitral valve is normal in
structure and function. Physiologic mitral regurgitation is noted.

AORTIC VALVE
The aortic valve is trileaflet. Mild aortic valve sclerosis with preserved
opening. Trace aortic regurgitation.

TRICUSPID VALVE
The tricuspid valve is normal. Physiologic tricuspid regurgitation is
noted.

PULMONIC VALVE
The pulmonic valve is grossly normal. Mild pulmonic valvular regurgitation.

AORTA/PULMONARY ARTERY
The aortic Sinus of Valsalva is normal in size. The Aortic Sinus(es) of
Valsalva measures 3.9 cm. Indexed Aortic Sinus(es) of Valsalva are 1.7
cm/m2. (normal <=2.1cm/m2). Borderline dilated ascending aorta. The
ascending aorta measures 4.2 cm. Indexed ascending aorta is 1.9 cm/m2.
(normal <=1.9cm/m2). The pulmonary artery is not well visualized.

PERICARDIUM/PLEURAL
There is no pericardial effusion.

MMode/2D Measurements & Calculations
RVDd1(nl <4.2cm): 4.5 cm LVIDd (3.8-5.8): 5.8 cm
RVDd2(nl <3.6cm): 3.3 cm LVIDs (2.3-3.9): 4.0 cm
IVSd (0.6-1.1): 1.5 cm LVPWd (0.6-1.1): 1.4 cm

__________________________________________________ __________________________
LV mass(C)d: 389.4 grams Ao sinus diam: 3.9 cm
LV mass idx (F<96,M<116g/m2): 177.3 grams/m2 AO sinus indexed: 1.7 cm
Relative Wall Thickness: 0.46 asc Aorta Diam: 4.2 cm
asc AO indexed: 1.9 cm

__________________________________________________ __________________________
LVOT diam: 2.4 cm
LA area AP2: 28.5 cm2
LVOT area: 4.7 cm2 LA area AP4: 28.3 cm2
LA shortest length: 5.5 cm
LA VOLUME (indexed): 56.5


__________________________________________________ __________________________
EDV(MOD-bp): 132.4 ml RA area AP4: 22.8 cm2
RA length: 5.8 cm
EDV(MOD-bp) indexed: 60.3 ml/m2 RA Volume Indexed: 39.6 ml/m2
ESV(MOD-bp): 60.4 ml TAPSE(nl >=1.7cm): 2.4 cm
EF(MOD-bp): 54.3 %
SV(MOD-bp): 71.9 ml

__________________________________________________ __________________________
IVC diam adult: 2.0 cm

Time Measurements
Aortic R-R: 0.96 sec
Aortic HR: 62.8 BPM

Doppler Measurements & Calculations
MV E max vel: 58.6 cm/sec Lat Peak E' Vel: 8.4 cm/sec
MV A max vel: 73.4 cm/sec Med Peak E' Vel: 8.0 cm/sec
MV E/A: 0.80 Lateral E/e' ratio: 7.0
MV dec time: 0.19 sec Average E/e' ratio: 7.2

__________________________________________________ __________________________
LV V1 max PG: 5.0 mmHg CO(LVOT): 6.3 l/min
LV V1 mean PG: 2.6 mmHg CI(LVOT): 2.9 l/min/m2
LV V1 max: 112.0 cm/sec SV(LVOT): 99.9 ml
LV V1 mean: 74.4 cm/sec SI(LVOT): 45.5 ml/m2
LV V1 VTI: 21.4 cm
LV dP/dt: 4039 mmHg/s

__________________________________________________ __________________________
RV S'(nl>=9.5cm/sec): 14.0 cm/sec TR max vel: 211.7 cm/sec
TR max PG: 17.9 mmHg
RVSP(TR): 20.9 mmHg
RAP: 3.0 mmHg
Mean PAP: 16.1

__________________________________________________ __________________________
Mean PAP (mmHg): 16.1 mmHg


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[charger69]

Grossly normal is good. Freaked me out when I saw it on mine but the doc kind of laughed and said "no, that is good. It means 'overall' or 'as a whole'"

What about the rest?


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[beanpo1e]

You have signs of chronic hypertension. Concentric hypertrophy in left ventricle is usually due to chronic hypertension as the ventricle is having to push harder against your arteries for a long period of time and is forced to get bigger. As a result, the pressure has backed up into your left atrium. The left atrium is more elastic than the left ventricle (kind of like a balloon). A "severely dilated left atrium" means its stretched out. This can lead to several different problems. The right side of your heart looks fine. Your valves look fine.

If you have other specific questions, feel free to PM me.

[charger69]

You have signs of chronic hypertension. Concentric hypertrophy in left ventricle is usually due to chronic hypertension as the ventricle is having to push harder against your arteries for a long period of time and is forced to get bigger. As a result, the pressure has backed up into your left atrium. The left atrium is more elastic than the left ventricle (kind of like a balloon). A "severely dilated left atrium" means its stretched out. This can lead to several different problems. The right side of your heart looks fine. Your valves look fine.

If you have other specific questions, feel free to PM me.

Could it have been the cycle I was on?


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[charger69]

@Charger69, did the doc review the results with you yet? I'm curious as to what they have to say. Results don't look bad to me but I am SO not a doctor.

Actually, the Dr was positive on the results because heart pumping functions have improved.
I was trying to get off the meds for afib but Dr says that it is a chronic condition and I should be monitored.
This all started because of a condition- non related- while I was on cycle.
First afib I was on clen , T3, ephedrine and cafeine one month out from a show- along with all of my cutting compounds and 700 mg of tren .
Be cautious with the stims guys! Especially if your an old goat. LOL


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[beanpo1e]

Glad to hear things are improving. Too much thyroid hormone can definitely instigate a fib by itself. In this case, with underlying structural cardiac issues, am guessing the stimulants exacerbated a problem that was just below the surface.