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Forum Name: Cardiology Symptoms

Question: Stress echo results


 belini - Thu Feb 03, 2005 6:34 pm

I received the report about a stress echo I had 2 weeks ago and I have a couple of questions.
First of all, I had the stress echo because at the time I was having severe SOB for no apparent reason. I got on the treadmill experiencing already shortness of breath and it continued through the entire test. Since then, that symptom has disappeared.
Here's the report:

"This patient exercised according to the Bruce protocol for a total of 10 minutes achieving a maximal heart rate of 172, which is 94% of predicted maximal rate. Exercise was discontinued due to shortness of breath. No chest pain was provoked by exercise. Blood pressure response to exercise was somewhat blunted. There are no abnormalities of the ST segment on resting EKG and with exercise, there is no ST segment depression or arrythmias seen. Resting echocardiogram shows normal left ventricular wall motion with just trace mitral regurgitation, trace tricuspid regurgitation with right ventricular systolic pressure of 22. With exercise there is increased contractility and no segmental abnormalities provoked.
Conclusions
1. No signs of ischemia in the form of chest pain, ischemic ST
segment depression or wall motion abnormalities on echocardiography.
2. Baseline echocardiogram with color and spectral Doppler
examination reveals normal left ventricular wall motion. No
significant valvular disease, just trace mitral regurgitation and
trace tricuspid regurgitation without evidence for pulmonary
hypertension.
3. Cardiorespiratory fitness classification is good with achievement
of 10 METs

Then it says that I don't need to see the doctor as the test was normal.

My question is, what is exactly trace mitral regurgitation and trace tricuspid regurgitation? Is it something common?

And the other thing I don't understand is the part about the blood pressure response being "blunted". I started with a blood pressure of 110/70 and peaked at 112/70. Could that be a problem?

I am a 36 year old female without any health issues in the past.
Thanks!
 Dr. Yasser Mokhtar - Tue Mar 01, 2005 8:48 pm

User avatar Dear Belini,

Your stress echo is normal.

Heart has 4 chambers, 2 on each side and every 2 chambers are separated by doors (valves), the function of which is to let the blood pass from one chamber to the other in a forward direction but not backwards. The word regurgitation refers to the backwards flow of blood through a valve.

Trace regurgitation of any of the heart valves is sometimes found in healthy patients who have echocardiograms for whatever reason. The machines have become very sensitive now that they pick everything even if this thing was not clinically relevant. You don't have to worry about this one bit.

The normal systolic (upper value) blood pressure response to exercise is to increase up to 160 (in younger patients such as yourself - 200 (in older patients). i am not sure how your blood pressure was obtained during exercise or whether the readings were accurate. The systolic blood pressure not increasing with exercise might have several causes including worse coronary disease (if the patient has coronary disease, which you don't), excessive reduction in systemic vascular resistance or just being dehydrated (i assume that they told you to come fasting on the day of the test).

i don't see any reason to worry about that either.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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