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Had Doppler Echocardiogram Do The Pulsatile Tinnitus It Showed Grade

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Posted on Sun, 9 Dec 2018
Question: Had Doppler echocardiogram do the pulsatile tinnitus it showed grade 1 diastolic dysfunction with everything else being within normal range nothing enlarged with mild mitral and aortic valve regurgitation my question is I've read online that this is a normal in a 59 year old female is that true or should I be followed by a cardiologist and have another echo as that one was over a year ago.
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Follow up: Dr. Ilir Sharka (0 minute later)
Had Doppler echocardiogram do the pulsatile tinnitus it showed grade 1 diastolic dysfunction with everything else being within normal range nothing enlarged with mild mitral and aortic valve regurgitation my question is I've read online that this is a normal in a 59 year old female is that true or should I be followed by a cardiologist and have another echo as that one was over a year ago.
doctor
Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome back on - Ask a Doctor - service!

I carefully reviewed your medical history and cardiac ultrasound information and would like to explain that your echo findings (mild mitral and aortic regurgitation, grade 1 diastolic dysfunction) have a trivial clinical importance.

Mild valvular regurgitations are frequently encountered in apparently normal individuals. They are not considered pathological and do not deserve special medical attention or echo followups.

From the other hand, mild diastolic dysfunction is commonly seen in patient with uncontrolled or long-lasting hypertension, who may XXXXXXX also some degree of left ventricular hypertrophy.

Nevertheless, with the individual aging this pattern becomes common and is considered a normal cardiac finding proportional with the individual age.

Coming to this point, properly controlling a possible hypertension is an important protective issue.

Regarding your pulsatile tinnitus, I would recommend checking your thyroid hormone levels for possible thyroid gland dysfunction and performing a brain MRI in order to exclude a possible brain vascular malformation.

Hope you will find this answer helpful!

Wishing all the best,

Dr. Ilir Sharka, Cardiologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome back on - Ask a Doctor - service!

I carefully reviewed your medical history and cardiac ultrasound information and would like to explain that your echo findings (mild mitral and aortic regurgitation, grade 1 diastolic dysfunction) have a trivial clinical importance.

Mild valvular regurgitations are frequently encountered in apparently normal individuals. They are not considered pathological and do not deserve special medical attention or echo followups.

From the other hand, mild diastolic dysfunction is commonly seen in patient with uncontrolled or long-lasting hypertension, who may XXXXXXX also some degree of left ventricular hypertrophy.

Nevertheless, with the individual aging this pattern becomes common and is considered a normal cardiac finding proportional with the individual age.

Coming to this point, properly controlling a possible hypertension is an important protective issue.

Regarding your pulsatile tinnitus, I would recommend checking your thyroid hormone levels for possible thyroid gland dysfunction and performing a brain MRI in order to exclude a possible brain vascular malformation.

Hope you will find this answer helpful!

Wishing all the best,

Dr. Ilir Sharka, Cardiologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (7 minutes later)
I do have longstanding high BP
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Follow up: Dr. Ilir Sharka (0 minute later)
I do have longstanding high BP
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Follow up: Dr. Ilir Sharka (0 minute later)
So grade 1 diastolic dysfunction doesn't necessarily progressed to the higher grades? Then what causes the higher grades to happen in people?
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Follow up: Dr. Ilir Sharka (0 minute later)
So grade 1 diastolic dysfunction doesn't necessarily progressed to the higher grades? Then what causes the higher grades to happen in people?
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Follow up: Dr. Ilir Sharka (0 minute later)
Brain MRI ok
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Follow up: Dr. Ilir Sharka (0 minute later)
Brain MRI ok
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Follow up: Dr. Ilir Sharka (2 minutes later)
No more questions promise thanks!
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Follow up: Dr. Ilir Sharka (0 minute later)
No more questions promise thanks!
doctor
Answered by Dr. Ilir Sharka (5 hours later)
Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again!

The best strategy to stop progressing grade I diastolic dysfunction in your case is having blood pressure values under control.

We have many cases that show mild diastolic dysfunction in the daily medical practice that do not progress to more severe stages; this is possible due to an appropriate medical treatment and followup strategy.

So, to conclude I strongly encourage you to frequently measure your BP values and refer them to your attending doctor. In the meantime life-style optimization including a physically active daily profile, body weight control, a healthy diet, avoiding close smoking contacts would be helpful in this regard.

Wishing you a pleasant weekend!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again!

The best strategy to stop progressing grade I diastolic dysfunction in your case is having blood pressure values under control.

We have many cases that show mild diastolic dysfunction in the daily medical practice that do not progress to more severe stages; this is possible due to an appropriate medical treatment and followup strategy.

So, to conclude I strongly encourage you to frequently measure your BP values and refer them to your attending doctor. In the meantime life-style optimization including a physically active daily profile, body weight control, a healthy diet, avoiding close smoking contacts would be helpful in this regard.

Wishing you a pleasant weekend!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (3 hours later)
So you first said it's normal and now you're telling me it can progress if my blood pressure is and kept under control this is why I'm so confused I can't get a straight answer so do I need a follow-up Doppler echo or not?
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Follow up: Dr. Ilir Sharka (0 minute later)
So you first said it's normal and now you're telling me it can progress if my blood pressure is and kept under control this is why I'm so confused I can't get a straight answer so do I need a follow-up Doppler echo or not?
doctor
Answered by Dr. Ilir Sharka (8 hours later)
Brief Answer:
Some more clarifications:

Detailed Answer:
Dear Janelle!

Let me give you some more details in this matter:

1. First degree diastolic dysfunction (or called also impaired relaxation pattern of left ventricular diastolic filling) is commonly found (around 50%) in elderly individuals and is considered a normal finding (as the body ages and also the heart starts to loose its elastic diastolic properties),

2. Even in younger patients first degree diastolic dysfunction may be seen and it may be considered not clinically important and a normal behavior of the cardiac physiology in some certain conditions, like uncontrolled high blood pressure, changes in the circulating blood volume, of heart rate, etc. Once the triggering factor is avoided or controlled the impaired relaxation will disappear. So, in this case the first degree diastolic dysfunction is reversible. This is true not only between two different individuals with different clinical conditions, but also in the same individual but in different time periods.

3. But, if these triggering factors are not well controlled (in your case high blood pressure) some important changes may happen to the heart (such as left ventricular hypertrophy if persistent high BP) and the first degree diastolic dysfunction will not only be persistent, but may even progress to more severe stages.

So, as you see the cardiac physiology is a bit complex, what is clinically trivial and reversible in one case, may be pathological and persistent in another.

Now, returning again to your case, we may say that once your high blood pressure is properly and steadily controlled, there is no place for concern; that mild diastolic dysfunction will not progress and may even disappear.

I tried to re-explain you in a more inclusive description.

Hope to have been more clear to your understanding!

Anyway, let me know in case you will need more clarifications.

Regards,

Dr. Iliri



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
Some more clarifications:

Detailed Answer:
Dear Janelle!

Let me give you some more details in this matter:

1. First degree diastolic dysfunction (or called also impaired relaxation pattern of left ventricular diastolic filling) is commonly found (around 50%) in elderly individuals and is considered a normal finding (as the body ages and also the heart starts to loose its elastic diastolic properties),

2. Even in younger patients first degree diastolic dysfunction may be seen and it may be considered not clinically important and a normal behavior of the cardiac physiology in some certain conditions, like uncontrolled high blood pressure, changes in the circulating blood volume, of heart rate, etc. Once the triggering factor is avoided or controlled the impaired relaxation will disappear. So, in this case the first degree diastolic dysfunction is reversible. This is true not only between two different individuals with different clinical conditions, but also in the same individual but in different time periods.

3. But, if these triggering factors are not well controlled (in your case high blood pressure) some important changes may happen to the heart (such as left ventricular hypertrophy if persistent high BP) and the first degree diastolic dysfunction will not only be persistent, but may even progress to more severe stages.

So, as you see the cardiac physiology is a bit complex, what is clinically trivial and reversible in one case, may be pathological and persistent in another.

Now, returning again to your case, we may say that once your high blood pressure is properly and steadily controlled, there is no place for concern; that mild diastolic dysfunction will not progress and may even disappear.

I tried to re-explain you in a more inclusive description.

Hope to have been more clear to your understanding!

Anyway, let me know in case you will need more clarifications.

Regards,

Dr. Iliri



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (6 hours later)
Sorry just saw your answer No my only follow-up question would be my blood pressures are consistently a little high like 145 over 92 in the mornings and then by the late afternoon they're normal or a little low any suggestions?
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Follow up: Dr. Ilir Sharka (0 minute later)
Sorry just saw your answer No my only follow-up question would be my blood pressures are consistently a little high like 145 over 92 in the mornings and then by the late afternoon they're normal or a little low any suggestions?
doctor
Answered by Dr. Ilir Sharka (3 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

I understand your concern and would explain that if your blood pressure values are constantly high in the morning everyday, they can lead to chronic changes to your blood vessels and heart, leading to an increased cardio-vascular risk (based on the new guidelines for arterial hypertension), although your blood pressure values are normalized during the afternoon.

For this reason, I would recommend starting a anti-hypertensive drug in the morning, at a low dose, for example an ACEI (lisinopril, ramipril, etc.) or a diuretic (hydrochlorothiazide), in order to reduce your blood pressure values.

You should discuss with your doctor on the above options.

Hope you will find this answer helpful!

Wishing all the best,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

I understand your concern and would explain that if your blood pressure values are constantly high in the morning everyday, they can lead to chronic changes to your blood vessels and heart, leading to an increased cardio-vascular risk (based on the new guidelines for arterial hypertension), although your blood pressure values are normalized during the afternoon.

For this reason, I would recommend starting a anti-hypertensive drug in the morning, at a low dose, for example an ACEI (lisinopril, ramipril, etc.) or a diuretic (hydrochlorothiazide), in order to reduce your blood pressure values.

You should discuss with your doctor on the above options.

Hope you will find this answer helpful!

Wishing all the best,

Dr. Iliri
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. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9533 Questions

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Had Doppler Echocardiogram Do The Pulsatile Tinnitus It Showed Grade

Had Doppler echocardiogram do the pulsatile tinnitus it showed grade 1 diastolic dysfunction with everything else being within normal range nothing enlarged with mild mitral and aortic valve regurgitation my question is I've read online that this is a normal in a 59 year old female is that true or should I be followed by a cardiologist and have another echo as that one was over a year ago.