What Do These Following Lab Reports Indicate?

Brief Answer:
I would explain as follows:

Detailed Answer:

Hello dear XXXXXXX

Welcome back on HCM!

I carefully reviewed your uploaded test results and would say that:

- Regarding your Holter monitoring, there has mainly been registered isolated ectopic beats (ventricular [I am sure that some of them are in fact aberrant supraventricular ectopic beats, because of their characteristic pattern] and supraventricular]), which are practically not considered complex arrhythmia.

In the absence of an important structural heart disease these isolated ectopic beats are not considered dangerous.

They could not be a rationale trigger for more complex life-threatening cardiac arrhythmia (like V tachy or V fib).

So, relax!

Meanwhile, those supraventricular runs (8 SV runs), though not dangerous in a structurally normal heart (no cardiomyopathy present), may be a source of unpleasant feeling (if prolonged episodes persist), leading even to dizziness, and even faintness.

Regarding those 5 ventricular runs, I am not sure they are all really ventricular (as the only one exposed on the Holter report is in fact supraventricular [occurred at 22:16] mistakenly considered ventricular by the Holter software]; not sure how the other 4 look, as not shown on the attached report).

Other aspect of Holter monitoring are normal: persisting sinus rhythm, R-R variability indexes, no clinically important ventricular pauses, etc.

- Regarding the possible triggering factors for that extrasystolic arrhythmia, I could say that, as potential several factors are excluded by the performed lab tests (no anemia, no thyroid dysfunction, no renal dysfunction, no electrolytes imbalances, no diabetes, no obvious cardiomyopathy), important alternatives to consider are:

(1) a slightly accelerated natural degenerative process of the cardiac structure components (special electrical conductance system, myocardium), leading to ectopic beats and aberrant conductance.

(2) a silent ischemic cardiac disorder, whic hmay be expressed by these arrhythmic phenomena.

- Regarding cardiac ablation as a possible strategy to manage these arrhythmic events, I would explain that facing the absence of clear evidence of complex persisting arrhythmia, and underlying cardiomyopathy, ablation could not be considered a necessary and therapeutic rationale strategy.

- Regarding therapy (beta-blocker, vasodilators), I would suggest that before deciding to proceed on them, to perform an exercise stress test (for investigating the above triggering factor alternatives (cardiac ischemia, etc), and also to closely monitor your BP values fora couple of days and to review them together.

- Regarding aortic calcification, the best way to possibly slow the progression, is to properly control the possibly influencing factor, like hypertension, renal dysfunction, smoking effect (exposure), an inappropriate diet (avoid fatty food), etc.

Hope to have been helpful to you!

Feel free to ask me in case of further uncertainties.

Kind regards,

Dr. Iliri

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Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Regarding your concern, I would explain that ventricular tachycardia (runs) are considered one of the most life threatening arrhythmias, because they directly affect ventricular chamber function, which are responsible for pumping blood through out the body and thus maintaining the vital functions.

While the supraventricular tachycardia (runs) by originating to the atria may only indirectly affect ventricular function, not being able to sufficiently desincronise ventricular contractions. In that way they don't generally affect too much the stroke volume cardiac output.

Nevertheless, if a preexisting cardiomyopathy is present supraventricular tachycardia may show as dangerous as ventricular tachycardia, in decreasing cardiac output and risking seriously the life.

Regarding the calcification of the aortic valve, I would say that it is impossible to cause heart enlargement or dilation if it is not severe enough as long as it is not associated with aortic valve dysfunction (markedly increased transvalvular gradients or important valvular regurgitation). If valvular calcification is associated with restricted valvular mobility then it may lead to important stenotic or regurgitant aortic valve and consequently causing a valvular cardiomyopathy (ventricular wall thickening and dilation).

All the above details are perfectly investigated by a careful cardiac ultrasound.

Regarding Lotensor, it could be safely used if you have persistent values of high blood pressure (above 140/90mm Hg).

Meanwhile a better control of risk factors like hypertension, diabetes, dyslipidemia, coupled with lifestyle modifications (diet modifications, avoiding smoking and performing a lot of physical activity would be very helpful to maintain a stable clinical situation.

Hope you will find this answer helpful!

Best wishes!

Dr. Iliri

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