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Forum Name: Cardiology Diagnostics

Question: Question about Echo results


 lsmith1 - Thu Feb 10, 2005 10:08 am

I have a question regarding echo results My EF is 53%, sinus rhythm with etopics and Morphologically normal aortic valve, Trivial mitral valve regurgitation,Mild tricuspid valve regirgitation,trivial pulmonary valve regirgitation. Everything else was normal, I was tested due to SOB and PVC's chest pain and just had a baby 3 1/2 months ago. Also 24 hour hoelter monitor showed highest heart rate at 149, 22 bigeminy runs, 1037 total ventricular beats, frequent VPCS singley and in runs of bigeminy. rare single SVPCS were seen. What does all this mean I am 23 and 122 lbs. Should I be worried? The doctor put me on a beta blocker and said I might have postpartum cardiomyopathy.
 Dr. Yasser Mokhtar - Fri Feb 18, 2005 10:52 am

User avatar Dear lsmith1,

The diagnosis of peripartum cardiomyopathy relies on dilatation of the left ventricle and systolic dysfunction of the left ventricle (low ejection fraction).

An ejection fraction of 53% is considered by many to be on the low normal (but normal) and you did not have a dilated left ventricle on the echo, so i am not sure that peripartum cardiomyopathy is the correct diagnosis. You have quite a bit of pvcs and bigeminy.

Arrhythmias can be caused by:
1. Mitral valve prolapse. Your echo did not show that.
2. Abnormality in the electrolytes levels in the blood. i recommend that you have a blood test to check for your electrolytes level.
3. Thyroid gland problem. i recommend that you have a blood test to check for your thyroid gland function.
4. Drinking caffeinated beverages. If you are drinking then cut down on the caffeine as much as you can.
4. Smoking. i hope you are not.
5. Drinking. i hope you are not.
6. Not getting enough sleep. i know with a 3.5 months old, you are probably not getting enough sleep, but try as much as you can to get some rest.
7. Coronary disease. Low probability in your case.

Shortness of breath can be caused by many causes starting from being physically unfit and ending with heart failure.

A beta blocker is a medication that will control the arrhythmias but this is just symptomatic treatment, the reason behind the arrhythmias has to be sought.

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

Yasser Mokhtar, M.D.
 lsmith1 - Fri Feb 18, 2005 7:09 pm

Thanks for your reply doctor. I have had my electrolytes checked and they were normal also have had my thyroid checked also normal. I do smoke and I do have a few glasses of red wine every night. I do not drink anything with caffine due to my ulcerative colitis, and I am not physically fit. My doctor already put me on a beta blocker but still does not know what is wrong with me. I have one doctor telling me it is anxiety and another telling me it is cardiomyopathy. I am so confused!
 Dr. Yasser Mokhtar - Mon Feb 21, 2005 2:23 pm

User avatar Dear lsmith1,

Thank you very much for the update.

Please, stop smoking and drinking, these simple measures help lots of patients get rid of their symptoms.

In my personal opinion, from what your echo shows, you don't have cardiomyopathy (at least not peripartum).

To be evaluated for cardiomyopathy, and if your doctor has not referred you to a cardiologist, i would recommend that you be referred to a cardiologist.

Anxiety can sometimes cause palpitations but i don't thin it causes pvcs unless you have severe stress with high levels of adrenaline.

Have the beta blockers helped your symptoms?

How about your other blood work, if you have anemia (low hemoglobin count), this can cause shortness of breath as well.

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

Yasser Mokhtar, M.D.
 lsmith1 - Mon Feb 21, 2005 2:40 pm

I have had lots of blood work done and all normal, that is why my doctors think I am crazy because everything always comes back perfect. I am trying to quit smoking but it is hard and I thought that a few glasses of red wine a day was good for your heart. The beta blockers have almost totally gotten rid of the PVC's but my heart rate is still high and I still have SOB and chest pain. SOB is probably from smoking, but the chest pain worries me. Obviously it is not a heart attack or I would be dead already but aren't beta blockers suppose to help angia? Maybe it is muscular from holding my child all the time. Today my big toes feel numb don't know what that is but it feels pretty weird. My doctors think that 53% is low EF for someone my age and I have a cardiologist consultation tomorrow morning. I go to Mayo and they are supposed to be the best so I guess I will see what he says. Thanks again for your replies.
 Dr. Yasser Mokhtar - Mon Feb 21, 2005 3:03 pm

User avatar Dear lsmith1,

Thank you very much for the update.

If by your doctor thinks you are crazy, you mean that he/she thinks you have panic attakcs, i don't think he/she thinks that, but panic attacks are known to cause chest pain and shortness of breath.

What do you mean by a few glasses of red wine every day? i suggest that you try and quit both smoking and drinking altogether and i know this is not easy.

Keep us posted on how your visit to the cardiologist turns out.

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

Yasser Mokhtar, M.D.
 lsmith1 - Tue Mar 15, 2005 4:09 pm

Hello Doctor sorry it took me so long to get back with you. I went to see a cardiologist and they said I was fine. He said to stay on the beta-blockers for a few more months and they will re-echo me and if it looks ok then I won't have to come back. They said my ejection fraction could have been low due to me having PVC's the whole time during the test.

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