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What Do Enlarged Heart Chambers Indicate?
Question: I had an echocardiogram and it showed an enlarged rt ventricle and lt atrium. Normal size left ventricle, but abnormal diastolic resting pressure. I have a high crp of
98, and cardiac specific c reactive protein was greater than 15. Borderline adenopathy in chest, multiple mesenteric lymph node enlargement, an adrenal adenoma on the rt side 1.4 cm. I am 6 feet tall, wt 200 lbs. I have had 2 episodes of multiple chest infiltrates, which cleared the first time, but when they reoccurred on follow up CT they had returned but in completely different areas of both lungs, I have chronic severe pain under rt rib cage but normal lfts, no sob, no cough, chronic high crp as noted, what is the significance of my heart chambers being enlarged and with a high hs-crp, how urgent is this?
98, and cardiac specific c reactive protein was greater than 15. Borderline adenopathy in chest, multiple mesenteric lymph node enlargement, an adrenal adenoma on the rt side 1.4 cm. I am 6 feet tall, wt 200 lbs. I have had 2 episodes of multiple chest infiltrates, which cleared the first time, but when they reoccurred on follow up CT they had returned but in completely different areas of both lungs, I have chronic severe pain under rt rib cage but normal lfts, no sob, no cough, chronic high crp as noted, what is the significance of my heart chambers being enlarged and with a high hs-crp, how urgent is this?
Brief Answer:
Not too serious, requires search for cause.
Detailed Answer:
Hi and thanks for the query,
A raised CRP ( C reactive Protein) deserves a proper evaluation. CrP is a maker of inflammation, generally an acute inflammation. This could indicate either an infectious process or at times, related to the presence of some tumors. It might be necessary however to get serial CrP measured, accompanied by another simple test for inflammation called an erythrocyte sedimentation rate. Based on these reading of both CrP and ESR, it might be necessary to follow up and know if it is acute or chronic. A complete blood count in the context of a raised CrP also remains important. If it reveals raised white blood cells with a predominantly raised neutrophil level (infection marker), this would indicate you have a bacterial infection, and treatment with appropriate antibiotics can then be envisaged. If other cell lines are still raised, possibility of a blood tumor like leukemkias are possibilities. It evaluataion depends on the clinical review of the day, the above suggested tests, specifics of medical, work and family history. All these could orientate the doctor to ask for other specific tests.
Enlarged heart chambers generally require a review to know exactly why they are enlarged. It is important to know if you are hypertensive, have a family history of heart disease, consume a lot of alcohol or experience symptoms like easily getting fatigued or coughing when you lie down. All these orientate towards a possibility heart disease (cardiomyopathy) or not. It is however for some persons, to naturally have enlarged heart chambers with no symptoms from birth (idiopathic cardiomyopathies). They however require a keen follow up. Not all enlarged heart chambers are a sign if serious disease. A clinical review and opinion, especially the follow up component from your doctor (cardiologist preferably) remains very important.
Kind regards,
Dr Bain
Not too serious, requires search for cause.
Detailed Answer:
Hi and thanks for the query,
A raised CRP ( C reactive Protein) deserves a proper evaluation. CrP is a maker of inflammation, generally an acute inflammation. This could indicate either an infectious process or at times, related to the presence of some tumors. It might be necessary however to get serial CrP measured, accompanied by another simple test for inflammation called an erythrocyte sedimentation rate. Based on these reading of both CrP and ESR, it might be necessary to follow up and know if it is acute or chronic. A complete blood count in the context of a raised CrP also remains important. If it reveals raised white blood cells with a predominantly raised neutrophil level (infection marker), this would indicate you have a bacterial infection, and treatment with appropriate antibiotics can then be envisaged. If other cell lines are still raised, possibility of a blood tumor like leukemkias are possibilities. It evaluataion depends on the clinical review of the day, the above suggested tests, specifics of medical, work and family history. All these could orientate the doctor to ask for other specific tests.
Enlarged heart chambers generally require a review to know exactly why they are enlarged. It is important to know if you are hypertensive, have a family history of heart disease, consume a lot of alcohol or experience symptoms like easily getting fatigued or coughing when you lie down. All these orientate towards a possibility heart disease (cardiomyopathy) or not. It is however for some persons, to naturally have enlarged heart chambers with no symptoms from birth (idiopathic cardiomyopathies). They however require a keen follow up. Not all enlarged heart chambers are a sign if serious disease. A clinical review and opinion, especially the follow up component from your doctor (cardiologist preferably) remains very important.
Kind regards,
Dr Bain
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My sed rate is normal, cbc normal, you didnt address the lymphadenopathy at all, i have had multiple crp labs done, neg RA, i am concerned being that my cardiac specific crp is so high, my adenopathy and repeated lung infiltrates and the possibility of cor pulmonale? I do not have HTN, i do have fatigue, All the info you wrote back can be found just by looking at the internet and i have already researched crp...the thing i cant find is the relation to the high crp, and the connection to the lymphadnopathy and abd pain and my risk of cardiac disease that is urgent to address...i must say that i expected more...at least why those 2 chambers are enlarged but not the other two? I am disappointed in having to pay for info easily looked up on the net.
Brief Answer:
Too early to bother much, hope this helps better
Detailed Answer:
Hi and thanks for the update,
I am sorry if I never addressed your questions, maybe as you expected. I think I could still contribute with regards to your concerns.
The concern of a cor pulmonale here is possible. Clinically, you do not present with such symptoms (wheezing, shortness of breath, swelling). Right ventricular hypertrophy supports this. However, cardiac catheterization might be be needed to be sure, especially in a context where you are clinically stable.
Infiltrates, lymphadenopathy and rib pain could indicate a lung disease. A simple viral infection could lead to enlarged lymph nodes. Normality of your complete blood count makes the possibility of an infection, a common cause of lymphadenopthy unlikely. Some rare bacteria like that which cause tuberculosis can cause lymph node enlargement. Your clinical history is not suggestive of this in this case.
The fact that the chambers to right are enlarged, not those to the left and the past history of pulmonary disease, infiltrates and lymphadenopathy raised concerns with regards to pulmonary hypertension for sure. However, I still think you need to stay calm and get these tests done again after a couple of weeks. You got a clinically stable clinical state in my opinion.
In case these do persist, associating a pulmonologist and a cardiologist in the evaluation would be worthwhile.
Based on clinical findings you describe, absence of any past history of hypertension and no remarkable family history, I do not think it is an emergency. However, the follow up and in depth investigation remain very important.
Thanks and kind regards,
Dr Bain
Too early to bother much, hope this helps better
Detailed Answer:
Hi and thanks for the update,
I am sorry if I never addressed your questions, maybe as you expected. I think I could still contribute with regards to your concerns.
The concern of a cor pulmonale here is possible. Clinically, you do not present with such symptoms (wheezing, shortness of breath, swelling). Right ventricular hypertrophy supports this. However, cardiac catheterization might be be needed to be sure, especially in a context where you are clinically stable.
Infiltrates, lymphadenopathy and rib pain could indicate a lung disease. A simple viral infection could lead to enlarged lymph nodes. Normality of your complete blood count makes the possibility of an infection, a common cause of lymphadenopthy unlikely. Some rare bacteria like that which cause tuberculosis can cause lymph node enlargement. Your clinical history is not suggestive of this in this case.
The fact that the chambers to right are enlarged, not those to the left and the past history of pulmonary disease, infiltrates and lymphadenopathy raised concerns with regards to pulmonary hypertension for sure. However, I still think you need to stay calm and get these tests done again after a couple of weeks. You got a clinically stable clinical state in my opinion.
In case these do persist, associating a pulmonologist and a cardiologist in the evaluation would be worthwhile.
Based on clinical findings you describe, absence of any past history of hypertension and no remarkable family history, I do not think it is an emergency. However, the follow up and in depth investigation remain very important.
Thanks and kind regards,
Dr Bain
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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