Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again, dear XXXX!

I am glad to hear from you again, and especially knowing you are following the right path to a healthy and long life.

I remember our last discussion and also reviewed again your echo report and let me declare that there is no reason to think you are at increased risk of any dangerous or life-threatening cardiac issues.

You are right about an increased sudden cardiac death rate in enlarged heart individuals.

But, this is absolutely not your case.

Your cardiac ultrasound report states that you have mild left ventricular concentric hypertrophy, but this is a frequent finding in obese or hypertensive individuals and doesn’t mean any cardiomyopathy such as hypertrophic or dilated cardiomyopathy (which are in fact the real risk for life-threatening cardiac arrhythmia an sudden death).

Furthermore, your cardiac chambers are within normal range; your left ventricle dimensions are normal and left atrial volume quite normal (when indexed by body surface area).

Cardiac valves are normally functioning and also right heart chambers are in good shape too.

Meanwhile, I have explained you the significance of the mitral valve deceleration time and tissue Doppler values (E/E’).

They are totally heart load dependent and quite reversible when the overall circulation conditions are brought to an optimal state (such as weight reduction and a healthy life-style).

So, nothing to worry about even at this point of concern.

Regarding slightly increased RVSP value (which reflects systolic pulmonary artery pressure), I would explain that once you properly control your chronic pulmonary disorder (optimizing your maintenance therapy) and decrease your body weight, it will resolve to nearly normal values.

You should know that overweight and especially obesity may lead to sleep apnea syndrome and obesity hypoventilation syndrome, which both predispose to cardiac arrhythmia and tendency of high blood pressure values.

That’s why the real challenge for you is not your heart but your body weight and pulmonary functional status.

By keeping this in mind, it would be easier finding the right way of XXXXXXX management and precautions.

In conclusion, I strongly encourage you keeping the ongoing pattern of life-style modifications and you will see that good results will be soon attained.

That’s my professional opinion.

I remain at your disposal for any further discussions whenever you will need.

Wishing you a pleasant weekend and a very Happy New Year!

Kind regards,

Dr. Iliri

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Brief Answer:
You are welcome!

Detailed Answer:
Dear XXXXXXX

I am glad to have been helpful to you!

I would be glad to review al your medical reports and discuss any medical issues you are concerned about!

Let me know about everything!

Wishing a Happy New year!

Dr.Iliri

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