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Echo-gram Showed Moderate Hypertrophy, Tricuspid Regurgitation, Aortic Insufficiency, Diastolic Dysfunction, Mild Pulmonary Hypertension. Help?

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Posted on Tue, 17 Jul 2012
Question: I had a echo tell me if I have chf or cad with these results.rvnormal,lv moderate hypertropy,mild pulmonic,mitral,tricuspid regurgitation,arotic insufficiency,diastolic dysfunction,biatrial enlargement,mild pulmonary hypertension,normal systolic,E:Aratio reversedles than 1,lvef50%
doctor
Answered by Dr. Jagdish (14 minutes later)
HI

Ejection fraction of 35-40% is required to confirm systolic heart failure. So you do not have systolic heart failure.


There is hypertrophy of of the left ventricle. As a result of this left ventricle chamber size is decreased. This is called Diastolic Heart Failure. Most common cause is high blood pressure. You need to strictly control the blood pressure.

These findings do not suggest CAD. Only way to know CAD is stress test or Coronary Angiogram.

In summary:
You have Diastolic Heart failure. Get the treatment for this. ACE inhibitors -lisinopril or ARBs- Losartan should be included in the treatment. Because of Pulmonary hypertension, calcium channel blockers like Amlodipine are useful.

Watch the symptoms of exacerbations of heart failure:
1. watch your weight weekly.
2. watch for swelling in swellings
3. Notice if the shortness of breath is getting worse
4. Notice whether you are frequently waking up in the night

If answers are YES, Heart failure is getting uncontrolled, so you need diuretics.


DISCLAIMER : This advice is based upon history as provided by the patient as there is no Physician – Patient relationship established. The patient has not been examined per se. The advice is not valid for medico-legal purposes. Please see a local doctor before acting upon the advice.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jagdish (17 minutes later)
had a stress test with reversible ischema ef 35%,ekg sinus rhythm rate 83 t wave abnormal,have edema,wake up night sweats,had XXXXXXX done with a problem of hemostasis what do all this mean with weight going up and down are you sure it is not chf my blood count white and red varies to
doctor
Answered by Dr. Jagdish (1 hour later)
Hi,

I feel that the sentence was not completed in the end.

EF (Ejection Fraction) while doing stress test is more accurate and if it is 35% which means you have systolic heart failure. Systolic or Diastolic failure, either of it can be called Congestive Heart failure.

Reversible ischemia means you have CAD (Coronory artery Disease). T wave abnormalities can mean ischemia(CAD).

With the above information, you possibly have congestive heart failure (both systolic and diastolic) along with coronory artery disease. I recommend you XXXXXXX a cardiologist with your ECHO report if you are still consulting a primary physician.

I wish you get well soon.


DISCLAIMER : This advice is based upon history as provided by the patient as there is no Physician – Patient relationship established. The patient has not been examined per se. The advice is not valid for medico-legal purposes. Please see a local doctor before acting upon the advice.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Jagdish

General & Family Physician

Practicing since :2000

Answered : 451 Questions

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Echo-gram Showed Moderate Hypertrophy, Tricuspid Regurgitation, Aortic Insufficiency, Diastolic Dysfunction, Mild Pulmonary Hypertension. Help?

HI

Ejection fraction of 35-40% is required to confirm systolic heart failure. So you do not have systolic heart failure.


There is hypertrophy of of the left ventricle. As a result of this left ventricle chamber size is decreased. This is called Diastolic Heart Failure. Most common cause is high blood pressure. You need to strictly control the blood pressure.

These findings do not suggest CAD. Only way to know CAD is stress test or Coronary Angiogram.

In summary:
You have Diastolic Heart failure. Get the treatment for this. ACE inhibitors -lisinopril or ARBs- Losartan should be included in the treatment. Because of Pulmonary hypertension, calcium channel blockers like Amlodipine are useful.

Watch the symptoms of exacerbations of heart failure:
1. watch your weight weekly.
2. watch for swelling in swellings
3. Notice if the shortness of breath is getting worse
4. Notice whether you are frequently waking up in the night

If answers are YES, Heart failure is getting uncontrolled, so you need diuretics.


DISCLAIMER : This advice is based upon history as provided by the patient as there is no Physician – Patient relationship established. The patient has not been examined per se. The advice is not valid for medico-legal purposes. Please see a local doctor before acting upon the advice.