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Q. ECG taken after COVID-19 infection shows mild LVH and grade 1 diastolic dysfunction. Can this be reversed?

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 19, 2020

Hello doctor,

I am a 35-year-male. I am non-diabetic, non-hypertensive (have family history of BP). My height 165 cm, and weight is 74kg. I am recently infected with COVID-19. I only had mild symptoms and got recovered. I observed that my heart rate increased to 80 -90 bpm on standing and 65-75 on lying position after COVID infection. After 16 days of my first symptom, I went for a general check up. I underwent 2D echo, ECG, HRCT chest.

My ECG showed early repolarization. In 2D echo, the impression was no RWMA, mild concentric LVH, Good LV systolic function, grade1 diastolic dysfunction, trivial TR with normal PAP. I am worrying about grade 1 diastolic dysfunction. Two years back, I tested 2D echo, then it was not there. Will it progress to worse? Can I revere this? Is there any chance of misdiagnosis?

#

Hello,

Welcome to icliniq.com.

Your heart rate is fine and it is normal to have such variation. In echo, the significant findings are mild concentric LVH (left ventricular hypertrophy) and diastolic dysfunction. Firstly, these are not anything serious and worrisome issues.

Mild concentric LVH may be a calculation error as it is mild only or another possibility is of intermittent high BP (blood pressure). So you should monitor your blood pressure intermittently just to be sure.

Diastolic dysfunction can also be fallacious. Also, diastolic dysfunction may accompany concentric LVH (if it is truly there), sometimes may be seen in otherwise normal individuals.

So these findings are benign and can be an error as well. Diastolic dysfunction may disappear with time especially with a healthy lifestyle like avoiding weight gain, healthy diet, and weight loss. So you should keep a watch over the blood pressure, have a healthy lifestyle, weight loss, and get an echo repeated after three or six months just to confirm the findings.

I hope this helps.

Thank you doctor,

I had mild concentric LVH in my first echo on June 2017, then after I got two more echo's after my first echo one year apart from each other. Reports did not mention mild LVH. 20 days back, when I checked randomly, my BP was 130/85. Now it came down to 120/80. For the past four months, I am using N95 along with surgical mask double protection. So I was breathing hard. Could it cause grade 1 diastolic dysfunction?

#

Hi,

Welcome to icliniq.com.

Mask would not cause this. However, if there is any recent weight gain, then it may contribute to a small extent. I do not think there is anything to worry about it. Finding of concentric LVH is probably an observer-dependent variation. Since it is mild, a slight error in taking measurements may put the value in the LVH range. BP of 130/85 is also fine and just monitor frequently for a week.


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