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Obese, Experienced Dyspnea With Exercise. Suspected Of Diastolic Dysfunction, ECG Showed Mild Enlargement Of Atrium And Valve. Advise?
Question: I am a 55 yr old slightly obese female who in the past few months has experienced severe dyspnea with exercise even just walking a short distance. My pulmonologist has a suspicion I have diastolic dysfunction. I just had an echocardiogram at it indicated a mild enlargement of the left atrium as well as mild mitral valve and tricuspid valve regurgitation. If all of this is mild, why am I experiencing such severe dyspnea? Atrium size 4.38cm
Brief Answer:
Cardiologic review, control cardiac ultrasound
Detailed Answer:
Hi and thanks for the query,
its interesting that you did an echocardiogram already. It is clear from what you describe that there is a lesion at the level of the heart. However, with these mild dysfunctions, I would suggestion the causes of the dyspnoea should also be searched out elsewhere. I am sure your pulmonologist must have asked to exclude any history of asthma, and done some spirometric (breathing and volumes analysis). If not, it should be done. Overweight on its own in some people could cause dyspnoea. Losing weight could also be of help.
I would however love to consider measures from a clinical point of view. Your cardiologist could be of utmost help. The cardiac ultrasound is operator dependent. It might be necessary to get it done again or by another specialist. It is not unusual also to have situations where the clinical scenario does not actually match, in terms of intensity, what is presented by the results.
I suggest you get a complete review by by a cardiologist, and a control cardiac ultrasound. A history of heart disease or notion if sudden death in the family tree could also be of importance to your doctor.
Thanks and kind regards.
Bain LE, MD
Cardiologic review, control cardiac ultrasound
Detailed Answer:
Hi and thanks for the query,
its interesting that you did an echocardiogram already. It is clear from what you describe that there is a lesion at the level of the heart. However, with these mild dysfunctions, I would suggestion the causes of the dyspnoea should also be searched out elsewhere. I am sure your pulmonologist must have asked to exclude any history of asthma, and done some spirometric (breathing and volumes analysis). If not, it should be done. Overweight on its own in some people could cause dyspnoea. Losing weight could also be of help.
I would however love to consider measures from a clinical point of view. Your cardiologist could be of utmost help. The cardiac ultrasound is operator dependent. It might be necessary to get it done again or by another specialist. It is not unusual also to have situations where the clinical scenario does not actually match, in terms of intensity, what is presented by the results.
I suggest you get a complete review by by a cardiologist, and a control cardiac ultrasound. A history of heart disease or notion if sudden death in the family tree could also be of importance to your doctor.
Thanks and kind regards.
Bain LE, MD
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I forgot to tell you that I was diagnosed the same time as the dsypnea began with pneumonitis from CT results. This was July. Also lab work was performed and at that time my BNP was 81. The BNP was repeated a week ago and it increased to 217. Could you explain what a control cardiac ultrasound is.
Brief Answer:
You need to consult a cardiologist.
Detailed Answer:
Hi and thanks for the updates,
A control ultrasound means you do an echography/ utrasound of the heart all over again. This is to be very sure of what s going on. As I mentioned, it is an exam that is very operator dependent.
The raised BNP is actually very suggestive a dysfunction at the level of the heart, and shall certainly deserve a review by a cardiologist.
You need to see a cardiologist for a review in my humble opinion. Thanks and kind regards.
Bain LE, MD
You need to consult a cardiologist.
Detailed Answer:
Hi and thanks for the updates,
A control ultrasound means you do an echography/ utrasound of the heart all over again. This is to be very sure of what s going on. As I mentioned, it is an exam that is very operator dependent.
The raised BNP is actually very suggestive a dysfunction at the level of the heart, and shall certainly deserve a review by a cardiologist.
You need to see a cardiologist for a review in my humble opinion. Thanks and kind regards.
Bain LE, MD
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your thoughtful opinion on this. I will seek a cardiology consult. I have an underlying overall feeling that something is very wrong. I am a nurse who is on medical leave at this moment because of this problem. But when I have a patient who states the same thing as me, they are usually right. You have to trust your basic instincts and mine is saying something is wrong. I did have a maternal grandfather die suddenly at 53 and my mother has a cardiac history but I related it to her smoking and severe COPD. I am trying to look at this professionally, but it is too personal. I know that it is difficult for you to say specifically what you really think. Lawsuits are too common. Everyone in the medical profession has to be very careful of anything said. My sense of your opinion is this is serious and I appreciate your help.
Brief Answer:
I do appreciate you too
Detailed Answer:
I will be honored and glad to chip in a thought if you deem it necessary anytime.
Thanks again and kind regards,
Bain LE, MD.
I do appreciate you too
Detailed Answer:
I will be honored and glad to chip in a thought if you deem it necessary anytime.
Thanks again and kind regards,
Bain LE, MD.
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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