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Q. I have LVH and diastolic dysfunction. How to correct the condition?

Answered by
Dr. Tanmai Yermal (jain)
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 19, 2020

Hello doctor,

I have been taking steroids on and off for the past three years. I got artial fibrallation a year ago (never again since then). My blood pressure was quite high 152/90 at the doctor. LV is normal and LVEDD is 53 mm, normal systolic function, no regional wall movement abnormalities.

LVH - 14 mm and beginning diastolic dysfunction (E/A=1, E/E‘ 8-15), LA 21 cm^2.

I already lost 24 kg and now I am weighing 110 kg at 194 cm, my goal is 93 kg. I also stopped steroids and now my blood pressure is 123/75. Will my diastolic function recover once I managed to reverse the LVH?

Dr. Tanmai Yermal (jain)

Cardiology General Medicine Internal Medicine
#

Hello,

Welcome to icliniq.com.

I have gone through your query. Can I know why were you on steroids? Was there any particular disease that was diagnosed and started you with steroids?

As there are many determinants causing diastolic dysfunction, one of the common cause is hypertension.

And yes, diastolic dysfunction is reversible in the majority of the cases over a period of time if you properly control your BP, obesity, and start doing regular exercise, consume a healthy diet, and lifestyle modification. You should also stop any addictions like smoking or alcohol if any. Also, get your blood sugar levels and thyroid profile checked.

Get back with details about your disease and indication for steroids for further discussion and management.


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Thank you doctor,

Sorry for not specifying, I have taken anabolic steroids for muscle growth.

I got my blood already checked some weeks ago.

TSH basal - 1,92 uU/ml (reference: 0.55 - 4.78).

Blood sugar basal 66 mg/dL. I fasted until blood test at 11 AM in the morning (reference: 70-100).

Would you recommend any medications like ACE even though my blood pressure is normal so it supports my heart recovery?

Dr. Tanmai Yermal (jain)

Cardiology General Medicine Internal Medicine
#

Hello,

Welcome back to icliniq.com.

Your lab reports of TSH (thyroid-stimulating hormone) and blood sugar levels are absolutely fine. Starting anti-hypertensive medications like ACE (angiotensin-converting enzyme) inhibitors depends on the overall average blood pressure. Just one reading will not be enough to take a decision.

What you can do is monitor BP for the next three to four days and measure at different times every day and keep a note of it (say, for example, today in the morning, tomorrow afternoon, and a day after in the evening or so). And then let us see if ACEI can be considered or not.

Second thing is, you are doing a good work of reducing your weight that will be more beneficial in keeping your metabolic profile under control. Please do continue doing regular exercise as well. And never think of starting any steroids again, as they have lots of side effects. Steroids per se for the sake of building muscle mass are not recommended.

You can have a healthy diet with so much proteins and an adequate quantity of fats and carbs along with vegetables and fruits, that itself is enough to built muscle mass and proper growth in a natural way. Anyways it is a past for you now. And get back to me in case you monitor your BP and for any other health advice you require.

I hope this helps.


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