34/Male, Extremely concerned about my Echocardiogram results

Posted by joejumbalya @joejumbalya, Oct 4, 2023

So I have a couple of uncles who've had heart issues at a relatively young age and I also suffer from extreme health anxiety. So I went and had an Electrocardiogram done just to make sure everything is ok and below are my results. The doctor hasn't called me about these they posted them on the web portal, I'm still waiting on a call back. But in the mean time I'm freaking out over these results, I usually work out especially cardio 5 days a week and try to watch what I eat. I'm in pretty decent shape I'm 5'11 185lbs. Should I be super concerned about these? The main ones I'm concerned about I put a @ sign in front of.

Interpretation Summary:
@ 1. Normal left ventricular size, wall thickness, wall motion, with low
normal
systolic function and ejection fraction of 50-55%. The average global
longitudinal strain is-14.8%, also indicative of mildly reduced function.

2. Normal right ventricular size and function.
@3. Borderline dilated aortic root measuring 3.6 cm in diameter.
4. No significant valvular abnormalities seen.
Narrative
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Echo Findings
Aortic Valve:
The aortic valve is trileaflet.
Aortic valve is mildly thickened.
Borderline aortic root dilatation.
Aortic root measures 3.6 cm in diameter.
No aortic stenosis.
There is no aortic regurgitation.
Mitral Valve:
The mitral valve is normal in structure and function.
There is trace mitral regurgitation.
Tricuspid Valve:
The tricuspid valve morphology and motion is normal.
There is trace tricuspid regurgitation.
Pulmonic Valve:
The pulmonic valve is not well visualized.
Right Ventricle:
The right ventricle is normal in size and function.
Pulmonary artery pressure could not be evaluated due to inadequacy of
tricuspid regurgitation jet.
Right Atrium:
The right atrium is normal in size.
Left Atrium:
The left atrium is normal in size.
Left Ventricle:
The left ventricle is normal in size.
There is normal left ventricular wall thickness.
@The left ventricular systolic function is low normal.
@Ejection Fraction = 50 - 55%
@The average global longitudinal strain is-14.8%, also indicative of
mildly
decreased left ventricular function.
The left ventricular wall motion is normal.
Pericardium:
The pericardium appears normal.
Diastology:
LA Volume Index = 22.18cc/m2.
E / E' = 6.03

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WELCOME to Connect @joejumbalya! You have come to a place to learn and share with others.
First things first, Mayo Connect cannot diagnosis conditions or offer medical advise...that is something you need to get from your doctor. Hopefully you will get answers to your questions soon, so you can put your mind at ease. Being young, 34, and in good shape with all the fitness, cardio, and diet is a definite plus for you! You mention you have heart disease in your family, do you know what your uncles were diagnosed with?
Have you called your doctor to discuss the findings yet, or do you have an appointment to go over the results?

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@karukgirl

WELCOME to Connect @joejumbalya! You have come to a place to learn and share with others.
First things first, Mayo Connect cannot diagnosis conditions or offer medical advise...that is something you need to get from your doctor. Hopefully you will get answers to your questions soon, so you can put your mind at ease. Being young, 34, and in good shape with all the fitness, cardio, and diet is a definite plus for you! You mention you have heart disease in your family, do you know what your uncles were diagnosed with?
Have you called your doctor to discuss the findings yet, or do you have an appointment to go over the results?

Jump to this post

Im not looking for a diagnosis really i just wanted to see if these results were considered abnormal. My Ejection Function of 50-55% is considered normal from what ive seen but when i see the terms they put like mildly and reduced function it scares me, and the global longitude number. They had their nurse call me for reassurance and to go over them and said just to do due diligence since the range was 50-55% they want to do a 14 day monitor and stress test on me. But then would tell me they don't see anything worrisome. So it confuses me and I suffer from health anxiety so it has my mind all over the place.

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Here's a good article on EF ... it seems to indicate, as your echo reviewer noted, that 50-55% is low normal. I am not a medical professional.

https://www.pennmedicine.org/updates/blogs/heart-and-vascular-blog/2022/april/ejection-fraction-what-the-numbers-mean

Almost everyone has some health issue - many not diagnosed. Start researching to understand better, and begin working a plan to improve your condition. Get second opinions.

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@joejumbalya

Im not looking for a diagnosis really i just wanted to see if these results were considered abnormal. My Ejection Function of 50-55% is considered normal from what ive seen but when i see the terms they put like mildly and reduced function it scares me, and the global longitude number. They had their nurse call me for reassurance and to go over them and said just to do due diligence since the range was 50-55% they want to do a 14 day monitor and stress test on me. But then would tell me they don't see anything worrisome. So it confuses me and I suffer from health anxiety so it has my mind all over the place.

Jump to this post

I’m not saying anything, I’m not a Dr. But MY ejection fraction was 47 one time when I was in my 30’s and I was a wreck. It was only one time. It can be read wrong as it really is just a guess, on what the dr sees. It is not an exact computation. I imagine they can go down or up at different times. Now my Ed is 60-65 regularly. Have it checked by a different Dr for sure before you get really worried.

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@joejumbalya ECHO's in my opinion don't seem to be what most Cardiologists rely solely on. In my situation after having a HA back in 2014 (66 at the time), my EF was measured at 30. I had been working out regularly for several years so after going through Heart Rehab at the hospital I went back to the gym and determined I would turn things around. Started off slow, but continued to build on things. A year later having my annual Echo, I was convinced it was going to be much stronger only to find out that there was no change!
I was very dissapointed because I worked very hard and felt really good. I decided after that to get a 2nd opinion and so I went to the Mayo Clinic in AZ for a day of testing, with a Stress Echo at the end. It was an amazing time and at the end of the day had a meeting with the Cardiologist that was following me through most of the testing that day and he said right at the top that my EF was easily above 40. He followed up with me 2 weeks later with his results and told me I was between 45-47. To this day my original Cardiologist still shows me at an EF of 30.
I am currently seeing a new Cardiologist in AZ (we are Snobirds) and he relies more on Heart MRI's over & above Echo's and refers to them as the Gold Std.
Second opinions are highly recommended in my opinion! Jim@ thankful

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It looks to me, semi-educated in these matters, but NOT a PhD/MD, that your results are rather good. I was looking to see mild-to-moderate thickening of the left atrial walls, but that does not appear on the report. Had you been in flutter or atrial fibrillation for much of the time, especially over many months, your l. atrium should be markedly enlarged. It is not; ergo, you almost certainly have not been in AF to any appreciable extent....if at all.

An angiogram might show if/to what extent you have plaque deposits in your coronary arteries, especially the left anterior descending, but a tomographical assessment would also show if it is partially stenosed. This might or might not be advised, but something you can discuss with your EP. On the face of it, reading the report you posted, it isn't likely that he/she would agree to it. But.....wouldn't hurt to ask. Also, a Doppler ultrasound of the carotid arteries helps to see what their condition is. My 85 year old dad was found to be 100 blocked on one side, 90% on the other. His vascular surgeon wouldn't touch the completely occluded side, but ran a stent around the other. My dad is still with us, now 93. I tell you this just as a frame of reference. Some need it, some don't. Maybe, in time, this is something you and your advisors can consider if you ever develop any significant atherosclerosis.

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Thank you all for these responses, the cardiologist wanted to put me on 4 medicines 1 at a time. I was terrified and in shock, when the nurse originally called me she said there was nothing overly concerning. So I scheduled appointment to discuss results with cardiologist. She wanted me on meds and more testing. I asked her hypothetically if my EF was 60% instead of 50-55 would she recommend medicine or more testing. She said no. Does that 5% difference really equate to me needing medicated??! Anyway obviously I'm freaking out, I scheduled an apt with another cardiologist to get a 2nd opinion before making such a big decision about medicines.

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What meds?

If the second cardiologist wants the same meds, will you continue to second guess the professional caregivers?

Not meaning to sound aggressive, but without specifics on the meds recommended?

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High blood pressure meds, she said she thinks I have high blood pressure bc it was high at the Dr office which it always is, especially this time cus i was sn anxious mess. I check my BP every week in the morning 3 times and brought her a print out of my readings for the past 3 months and my average was 125/83 whichshe completely disregarded, she is convinced I have high BP due to my 50-55% EF score. I think she wanted to start me on Metroplol as well. Then she said if those 2 were tolerated well she wanted to get me on 2 more later on. I just felt like that was way out of left field that's why i wanted to get a second opinion. If the second Dr agrees with her then I'll do what I have to do. I just felt like that was kind of sudden. Especially when she mentioned that if my EF was 5% higher she wouldn't recommend any medicine or further tests. Whole thing has me freaking out

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