Q. My chest x-ray shows heart enlargement and I have intermittent palpitations. What to do?

Answered by
Dr. Ilir Sharka
and medically reviewed by iCliniq medical review team.
Published on Nov 21, 2019

Hello doctor,

I had bronchitis and they did a chest x-ray, it showed my heart was enlarged. My primary doctor did an echo and the results are below. My family history, maternal grandfather died of a blood clot that went to his heart and caused a heart attack. Mother died after a heart valve surgery in the early '50s, right ventricular failure and she had pulmonary hypertension. My brother just had a triple bypass for blockages two weeks ago. My personal health issues are high blood pressure well-controlled, sleep apnea, morbid obesity, acid reflux, IBS, peripheral edema, small hiatal hernia, anxiety well controlled. My primary doctor said the echo results were nothing to be concerned with at this point and want to retest in a year. However, I had an echo done five years ago and none of these issues were present then. With family and personal history what do you think? Only symptoms would be intermittent palpitations (not too often) and SOB on greater exertion.

Procedure: A complete two-dimensional transthoracic echocardiogram was performed (2D, spectral and color flow doppler).

Interpretation:

Summary: Contrast injection was performed due to suboptimal images.

Left ventricular systolic function is normal. The visually estimated left ventricular ejection fraction is greater than 55%. There is a mild left ventricular hypertrophy present. Respiratory variation of the IVC indicates normal right atrial pressures. The left atrium is mildly dilated. There is a trace amount of mitral regurgitation. The tricuspid regurgitant signal is inadequate for evaluating right ventricular pressure. There is a trace tricuspid valve regurgitation. No hemodynamically significant valvular aortic stenosis. No aortic regurgitation is present. There is no pericardial effusion.

Left ventricle: The left ventricle is normal in size. There is no thrombus. There is mild left ventricular hypertrophy present. Left ventricular systolic function is normal. The visually estimated left ventricular ejection fraction is greater than 55%. The left ventricular wall motion is normal.

Right ventricle: The right ventricle is normal in size. The right ventricular systolic function is normal.

Atria: The left atrium is mildly dilated. Right atrial size is normal. Respiratory variation of the IVC indicates normal right atrial pressures.

Mitral valve: The mitral valve leaflets appear normal. There is no evidence of stenosis, fluttering, or prolapse. There is a trace amount of mitral regurgitation.

Tricuspid Valve: The tricuspid valve is normal. There is no tricuspid valve vegetation. No significant tricuspid stenosis. There is trace tricuspid valve regurgitation. The tricuspid regurgitant signal is inadequate for evaluating right ventricular pressure.

Aortic valve: The aortic valve is trileaflet. There is no aortic valvular vegetation. No hemodynamically significant valvular aortic stenosis. No aortic regurgitation is present.

Pulmonic valve: The pulmonic valve leaflets are thin and pliable, valve motion is normal. There is no pulmonic valvular stenosis. There is trace of pulmonic valvular regurgitation.

Great vessels: The aortic root is normal in size.

Pericardium / pleural: There is no pericardial effusion.

Thrombus / mass: No intracardiac masses identified.

MMode / 2D Measurements:

RVDd: 3.4 cm

LVIDd: 4.9 cm

IVSd: 1.1 cm

LVIDs: 3.0 cm

LVPWd: 1.2 cm

FS: 37.6 %

Ao root diameter: 3.1 cm

EDV(Teich): 112.0 ml

Ao root area: 7.5 cm2

ESV(Teich): 36.4 ml

LA dimension: 3.3 cm

EF(Teich): 67.5 %

LA/Ao: 1.1

LVOT diam: 2.0 cm

LVOT area: 3.1 cm2

Doppler Measurements \T\ Calculations

MV E max vel: 100.0 cm/sec MV

V2 max: 98.8 cm/sec

MV A max vel: 93.0 cm/sec

MV max PG: 3.9 mmHg

MV E/A: 1.1

MV V2 mean: 69.4 cm/sec

MV mean PG: 2.0 mmHg

MV V2 VTI: 33.6 cm

MVA(VTI): 2.7 cm2

MV P1/2t

max vel: 99.8 cm/sec

Ao V2 max: 157.0 cm/sec

MV P1/2t: 61.2 msec

Ao max

PG: 9.9 mmHg MVA(P1/2t): 3.6 cm2

Ao V2 mean: 105.9 cm/sec

MV dec slope: 477.0 cm/sec2

Ao mean PG: 5.5 mmHg

Ao V2 VTI: 33.4 cm

AVA(I,D): 2.7 cm2

AVA(V,D): 2.9 cm2

LV V1 max PG: 8.2 mmHg

SV(LVOT): 90.2 ml

LV V1 mean PG: 4.0 mmHg

LV V1 max: 143.0 cm/sec

LV V1 mean: 91.8 cm/sec

LV V1 VTI: 28.7 cm

PA V2 max: 119.0 cm/sec

PA max PG: 5.7 mmHg

PA V2 mean: 72.6 cm/sec

PA mean PG: 2.5 mmHg

PA V2 VTI: 22.1 cm.

Dr. Ilir Sharka

Cardiology
#

Hello,

Welcome to icliniq.com.

I passed carefully through your medical history and cardiac ultrasound report. Your echo data seem to be fine, only there is a mild left atrial dilation. You cannot change your family history, but you can change and modify your lifestyle and your diet. The most important issues are to reduce your body weight, control your anxiety disorder, follow a physically active daily regimen. You should check your fasting blood, lipid profile, and glucose, and look after your blood pressure values.


Was this answer helpful?

 | 

Thank you doctor,

The information helps to ease my mind. My blood pressure (last reading was 118/78 mmHg) and anxiety with medicines and therapy are very well controlled now. I am working on losing weight and I have recently lost 20lbs and I am actively working on losing more. My last fasting blood values were as follows.

Glucose 99 mg/dL Cholesterol 188 mg/dL Triglyceride 69 mg/dL Non-HDL cholesterol 141 mg/dL Cholesterol / HDL ratio 4.00 LDL cholesterol 127 mg/dL HDL cholesterol 47 mg/dL. I want to ask a couple more questions if you do not mind:

Any ideas what could have caused the LVH? Any worries about life expectancy with this issue? Any restrictions on exercise, or yard and house work with this issue?

Dr. Ilir Sharka

Cardiology
#

Hello,

Welcome back to icliniq.com.

Your blood lipid profile is perfectly normal. So, in my opinion, the mild LVH could be attributed to different possible issues:

Arterial hypertension,

Genetics (family history for cardiac disease),

Obesity,

Sleep apnea (which is known to be an independent cardio-vascular risk factor).

I do not think that this echo finding will change anything in your life expectancy, especially if you follow a healthy lifestyle and maintain normal blood pressure values. I would just advice trying to lose some pounds. It would help also improve sleep apnea. Consulting with a dietician would be helpful in this regard. I would also recommend performing regular physical activity, which is really helpful for a healthy mind and heart.

I hope this helps.


Was this answer helpful?

 | 

Ask a QueryAsk a Query Consult by PhoneConsult by Phone Video ChatVideo Chat
Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers


I have palpitations and premature beats since childhood. Should I be worried?

Query: Hello doctor, I am a 48 year old male. I have a lean build and do exercises regularly. Since childhood, I had a tendency for heart palpitations and premature beats, mostly when I do not get good sleep or if I am going through some stress. Around 16 years ago, I consulted a cardiologist and had an ...  Read Full »

Popular

Popular

Ask your health query to a doctor online?

Ask a Cardiologist Now

* guaranteed answer within 4 hours.
Enter Your Health Query
You can upload files and images in the next step.

Fee:  

 


Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.