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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Diastolic Dysfunction And Left Ventricular Hypertrophy

Hi: I m a 53 year old female. Last Sunday I had a frightening pain that was between my shoulder blades that lasted approximately 5 minutes. I went to Urgent Care where they did an ECG which they said was slightly abnormal. They transported me to ER where another ECG was done that was slightly abnormal. Cardiac Enzyme testing came back negative and then 4 hours later they did another one which was negative. They referred me to a cardiologist who I saw the next day. They scheduled me for a nuclear stress test and an echocardiogram. I went back for results and I only saw teh Physicians Assistant. She told me the ECG on the stress portion showed a mild old septal wall MI in my past ?? The echocardiogram said I had mild left ventricular hypertrophy with GRADE 1 (relaxation abnormality) diastolic dysfunction. I had some trace tricuspid and mitral regurgitation. I decided to get a second opinion because they wanted to do another test. The new cardiologist stated that he did not think I had a heart attack and only wanted to put me on a Beta Blocker. I m not sure who to believe. Also, I was uncertain as to another thing, on the Nuclear Stress Test it said I had an effusion fraction of 92% and on the echocardiogram it said it had visually a EF of 65%, which one of these is correct. If it is 92% it should be concerning, right? I do not know if I should go to another cardiologist and see what they think or which one to trust.
Wed, 16 Dec 2015
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Orthopaedic Surgeon 's  Response
hello
Old MI may have been missed as often silent heart attacks are there, your current doctor rightly tells you that at present there is no new heart attack only left ventricular enlargement which may be due to high BP.Diastolic dysfunction is not that risky as a systolic dysfunction and surely your cardiologist know well,.Your EF is normal at 65% means ventricular contraction power is good, so nothing to worry. Nuclear test showing effusion fraction 92% may not be worrying your doctor as may well be within normal confines.Trust the senior cardiologist who has seen you and follow his advice for treatment.Normal cardiac enzymes also rule out new heart attack. Dont worry. Consult the cardiologist you last met
thanks
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Suggest Treatment For Diastolic Dysfunction And Left Ventricular Hypertrophy

hello Old MI may have been missed as often silent heart attacks are there, your current doctor rightly tells you that at present there is no new heart attack only left ventricular enlargement which may be due to high BP.Diastolic dysfunction is not that risky as a systolic dysfunction and surely your cardiologist know well,.Your EF is normal at 65% means ventricular contraction power is good, so nothing to worry. Nuclear test showing effusion fraction 92% may not be worrying your doctor as may well be within normal confines.Trust the senior cardiologist who has seen you and follow his advice for treatment.Normal cardiac enzymes also rule out new heart attack. Dont worry. Consult the cardiologist you last met thanks