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How Serious Is Aortic Sclerosis? What Steps Should I Take To Improve This?
Question: I am male 63 years and have IGA nephropathy and hypertension since May 2010 which is being treated with Cardace 10 mg, Stamlo 5 mg, Rosuvas 10 mg, and fish oil capsules .
In addition, I have thyroid nodules - no treatment, a benign prostrate (32 cc, Grade 2) – tablet Urimax D. BP is around 120/70. I exercise daily for about 45 minutes.
I attach my latest ECG and Echo reports in August 2024 as well as the earlier Echo report in August 2022. In both my latest reports, due to my anxiety while taking the test (I have white coat hypertension), my pulse rate was over 100 bpm and this was observed as Sinus Tachycardia. In normal circumstances my BP is regularly around 120/70 and pulse rate between 60 – 70 bpm due to regular exercise.
I would be grateful if you could review my ECG and Echo reports and provide your opinion. I have the following queries:
1) The August 2024 reports mentioned concentric LV hypertrophy. This was also mentioned in my Echo report in XXXXXXX 2018, but subsequent Echo reports in July 2019 and August 2022 did not mention this. Does this keep changing or could it also be due to measurement differences?
2) How serious is Aortic sclerosis? What steps should I take to improve this?
3) How serious is the Mitral Valve buckling and trivial regurgitation, and the trivial tricuspid valve regurgitation ? Does this along with LV hypertrophy indicate that I now have heart disease ?
4) My EF is 62% but in August 2022 it was 71 % - what could be the reason for this lower EF? Is it a cause for
concern ?
Thanks
In addition, I have thyroid nodules - no treatment, a benign prostrate (32 cc, Grade 2) – tablet Urimax D. BP is around 120/70. I exercise daily for about 45 minutes.
I attach my latest ECG and Echo reports in August 2024 as well as the earlier Echo report in August 2022. In both my latest reports, due to my anxiety while taking the test (I have white coat hypertension), my pulse rate was over 100 bpm and this was observed as Sinus Tachycardia. In normal circumstances my BP is regularly around 120/70 and pulse rate between 60 – 70 bpm due to regular exercise.
I would be grateful if you could review my ECG and Echo reports and provide your opinion. I have the following queries:
1) The August 2024 reports mentioned concentric LV hypertrophy. This was also mentioned in my Echo report in XXXXXXX 2018, but subsequent Echo reports in July 2019 and August 2022 did not mention this. Does this keep changing or could it also be due to measurement differences?
2) How serious is Aortic sclerosis? What steps should I take to improve this?
3) How serious is the Mitral Valve buckling and trivial regurgitation, and the trivial tricuspid valve regurgitation ? Does this along with LV hypertrophy indicate that I now have heart disease ?
4) My EF is 62% but in August 2022 it was 71 % - what could be the reason for this lower EF? Is it a cause for
concern ?
Thanks
Brief Answer:
I would explain:
Detailed Answer:
Hello!
I passed carefully through your medical history and uploaded tests and would explain as follows:
1) The difference in reporting intermitently LV concentric hypertrophy is a matter of measurement precision and accuracy and not a certain pathological pattern progression.
2) Aortic sclerosis doesn't seem to be of important consequences. No important aortic valve dysfunction is present. The only thing to do in this regard is properly controlling cardiovascular risk factors and chronic nephropathy.
3) You don't actually have any clinically important valvular dysfunction; so relax and don't worry too much about that.
4) EF variability is a matter of measurement accuracy; nothing to worry about!
Hope to gave been helpful to you!
Let me know in case of any further questions.
Kind regards,
Dr. Ilir Sharka
cardiologist
I would explain:
Detailed Answer:
Hello!
I passed carefully through your medical history and uploaded tests and would explain as follows:
1) The difference in reporting intermitently LV concentric hypertrophy is a matter of measurement precision and accuracy and not a certain pathological pattern progression.
2) Aortic sclerosis doesn't seem to be of important consequences. No important aortic valve dysfunction is present. The only thing to do in this regard is properly controlling cardiovascular risk factors and chronic nephropathy.
3) You don't actually have any clinically important valvular dysfunction; so relax and don't worry too much about that.
4) EF variability is a matter of measurement accuracy; nothing to worry about!
Hope to gave been helpful to you!
Let me know in case of any further questions.
Kind regards,
Dr. Ilir Sharka
cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for your prompt and as always informative responses.
The reason for my concern with LV hypertrophy was that the measurement of both the LVPW (ed) at 1.2 cm (Echo August 2022- 0.9 cm) and the IVS (ed) at 1.3 cm (Echo August 2022- 0.9 cm) were outside the normal range of 0.6 cm - 1.10 cm. My follow-up queries are:
1. Are the outside range LVPWed and IVSed measurements something I should be concerned about?
2. When are LVPW (ed) and the IVS (ed) measurements outside the normal range considered to be significant?
3. I am currently on Cardace 10 mg and Stamlo 5 mg -morning daily. Is any change in the medication dosage required given my latest ECG and Echo reports?
Thanks very much.
The reason for my concern with LV hypertrophy was that the measurement of both the LVPW (ed) at 1.2 cm (Echo August 2022- 0.9 cm) and the IVS (ed) at 1.3 cm (Echo August 2022- 0.9 cm) were outside the normal range of 0.6 cm - 1.10 cm. My follow-up queries are:
1. Are the outside range LVPWed and IVSed measurements something I should be concerned about?
2. When are LVPW (ed) and the IVS (ed) measurements outside the normal range considered to be significant?
3. I am currently on Cardace 10 mg and Stamlo 5 mg -morning daily. Is any change in the medication dosage required given my latest ECG and Echo reports?
Thanks very much.
Brief Answer:
I would explain:
Detailed Answer:
Hello again!
Let me explain that concentric left ventricular hypertrophy may be primarily explained by long-standing not properly controlled high blood pressure.
1) It is necessary to timely detect any signs of left ventricular hypertrophy, especially when further progression is noted even on anti-hypertensive therapy. In this latter case the situation may be considered important and therapeutic intervention is required.
2) If increased wall thickness is associated with left ventricular diastolic stiffness and signs and symptoms of heart failure appear, then LV hypertrophy is considered clinically significant. Several imagine tests parameters and certain lab tests (like BNP) may detect even subtle changes and guide therapy.
3) Coming to this point, it would be recommended a close blood pressure monitoring for at least several days, in order to properly decide further therapy modification.
Kind regards,
Dr. Iliri
I would explain:
Detailed Answer:
Hello again!
Let me explain that concentric left ventricular hypertrophy may be primarily explained by long-standing not properly controlled high blood pressure.
1) It is necessary to timely detect any signs of left ventricular hypertrophy, especially when further progression is noted even on anti-hypertensive therapy. In this latter case the situation may be considered important and therapeutic intervention is required.
2) If increased wall thickness is associated with left ventricular diastolic stiffness and signs and symptoms of heart failure appear, then LV hypertrophy is considered clinically significant. Several imagine tests parameters and certain lab tests (like BNP) may detect even subtle changes and guide therapy.
3) Coming to this point, it would be recommended a close blood pressure monitoring for at least several days, in order to properly decide further therapy modification.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response.
My last follow up question - am I correct in assuming that based on the ECG (Aug 24) and Echo reports ( Aug 24 and July 22) provided to you, your view is that the LV hypertrophy appears to be more a measurement issue rather than actual progressive LV hypertrophy ?
Thanks and regards
My last follow up question - am I correct in assuming that based on the ECG (Aug 24) and Echo reports ( Aug 24 and July 22) provided to you, your view is that the LV hypertrophy appears to be more a measurement issue rather than actual progressive LV hypertrophy ?
Thanks and regards
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello again!
I would explain that in such a ther short period (2 years( left ventricular hypertrophy progression could be hardly detected. Yes those echo tests should be more consistent, as measurement issues appear to be a problem. Anyways, a cardiac MRI exam would definitely resolve this issue as it is considered the gold standard for cardiac morpho-functional assessment and tissue characterization with high precision and accuracy.
Let me know in case of any further questions.
Kind regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello again!
I would explain that in such a ther short period (2 years( left ventricular hypertrophy progression could be hardly detected. Yes those echo tests should be more consistent, as measurement issues appear to be a problem. Anyways, a cardiac MRI exam would definitely resolve this issue as it is considered the gold standard for cardiac morpho-functional assessment and tissue characterization with high precision and accuracy.
Let me know in case of any further questions.
Kind regards,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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