What Casues Difference In Value Of LV Diastolic Diameter?

Posted on Sun, 29 Jun 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 29 Jun 2014 Answered on

Mon, 21 Jul 2014 Last reviewed on

Question : I have been having chronic chest pain and palpitations for around one year. All tests (EKG, Echo, blood, x ray) appeared to be normal except a holter monitor revealed second degree AV block leading to premature ventricular contractions and bradyarrythmia. I am scheduled to see an electrophysiologist next month. That is my background. My question involves echocardiograms. I have had an echocardiogram last year and another this year, and there is a discrepancy between the two. Last year my LV diastolic diameter on the first exam was 49mm and the systolic was 30mm with an ejection fraction of 69%. One year later the LV diastolic diameter was 54 mm and the systolic 34mm with an ejection fraction of 66%. Although both are in normal range, is there any chance the difference could be from doctor calculations or perhaps a difference in blood pressure during the day of the test or could this signify an enlarging left ventricle and the beginning of dilated cardiomyopathy?

Answered by Dr. Sukhvinder Singh (3 hours later)

Brief Answer:
Please see below.

Detailed Answer:
Dear Sir
The hallmark of dilated cardiomyopathy is decrease in ejection fraction beside dilatation of left ventricle, hence it can not be said that this is even the beginning of same (at an EF of 66%).
There can be various reason of this small changes in dimensions and EF. This may be related to the volume status on that day, the sympathetic drive on that day and the operator variability. Operator variability may be related to technique, experience, method used etc.
If you are asymptomatic (no shortness of breath/ easy fatigability etc) then this small change is not significant. More light on same can be thrown by your doctor. If he does not find any abnormality on clinical examination, then likelihood of this change being a normal variant is again high.
Hope this provides some insight.
Feel free to discuss further.
Sincerely
Sukhvinder

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