Help interpreting echocardiogram

Hi all

I am 29 now, had afib since 27. I had an echocardiogram last year and there are some things in the report that worry me. The cardiologist never showed me the report but simply said my heart was structurally normal (other than being on afib meds of course). People on here seem to be really knowledgeable with heart stuff and I am having a hard time navigating all these terms on google. Here is a copy of my report:

[imgur.com]

A few things that worry me are:

1. It says I have a small atrial septal defect or patent foramen ovale which I was not told about. From what I can find on google this is a hole in the heart and can greatly reduce life expectancy. Is this something to worry about? I wasn't even told. I know it says mine is "small" but I mean I wasn't even told...

2. "Aortic valve is trileaflet, slightly thickened with good overall mobility" - is thickened bad? remember this is a 28 year old heart and I am healthy and not overweight at all so the fact something is thickened sounds bad to me

3. "Mitral valve slightly thickened" as above

4. Right ventricle is towards the upper limits of normal with preserved systolic function". right atrium also towards upper limits of normal - could this be enlarging due to the atrial septal defect? Enlarging doesn't sound good to me...

5. IVC slightly dilated. When I google this it says a dilated inferior vena cava is a marker of poor survival.

6. In general what do all the numbers mean? I know in general sometimes hospitals will say everything is 'normal' merely because its within a normal range. I would prefer to know what is optimal - especially as I am very young and some things could be an indication of problems as I get older. What is normal for me shouldn’t be what is normal for an 80 yr old kind of thing.

If anyone is able to help me interpret what this means I would be grateful. It has me very worried but I do not have a cardiologist app for a month.



Edited 1 time(s). Last edit at 11/19/2019 03:56PM by Zb3.

1. Millions of people have small atrial septal defects (ASD), including me. It's nothing to worry about and it won't reduce your life expectancy.

2. A slightly thickened aortic valve is another thing millions of people walk around with harmlessly, including 28 year olds. It's nothing to worry about.

3. Same thing again. (See where this is going? )

4. No, it's not enlarging due to the ASD. Your atria are normal size.

5. You keep omitting the word "slightly" when you compare your results to what Dr. Google tells you. A slightly dilated IVC doesn't make a poor prognosis.

6. It's a perfectly normal echo. Nobody would lie to you about the numbers or gloss over them. They are indeed all normal for a 28-year old. I'm not going to explain every number because that's a waste of time for both of us. If you really want to know, head to Dr. Google and look them up one by one, but honestly, you don't need to do that.

It's not surprising that your cardiologist didn't mention these things because they're not worth mentioning, really. It's a perfectly normal echo.

My only concern would how well your afib is controlled. If you're in persistent afib or you're paroxysmal with a high afib burden, you really don't want to stay that way, especially at your age. A high afib burden is likely to lead to atrial enlargement over time, and that just makes afib more difficult to treat and more likely to become persistent. Remember the saying: afib begets afib. It's true.

Thanks for the reply. I understand mine says “slightly thickened” or “small asd” and therefore the prognosis is different but I guess I’m approaching it from the perspective of these are bad things and what if the thickening gets worse (i understand the asd will remain the same). Also “slightly” is quite subjective so it would be good to know to what extent it’s thickened or also where I could make lifestyle changes to improve my numbers.

My afib burden is nil because I am on flecainide and beta blocker daily

Best you can do is optimize your diet for your genotype. Enough sleep, mange stress, exercise normally - all the usual things. Keep your blood glucose level steady under 100, Dr Bernstein says 83 (4.6mmol/l)is optimal. Anticoagulation if you have frequent and long episodes - consult your EP.
Anyhow, that's what i try to do. Find it a bit difficult to achieve the Bernstein blood glucose levels throughout the day. And i take 50mg Flec/day
All the best!



Edited 1 time(s). Last edit at 11/20/2019 12:27AM by Joe.

Yeah, I get it. You're reading this report and it's full of stuff that sounds worrisome, but you have to understand what a bad report looks like in order to understand a good one. You have a good report. It's what a good one looks like. You have to remember that the doctor who wrote it wasn't writing it for you. They were writing it for other doctors, so you can't interpret it in layman thinking. You're interpreting things that are actually positives as being negatives.

By all means keep up regular visits with your cardiologist and keep an eye on your numbers, but you've got no reason to be stressing out about these results. They're good. And since your burden is nil there's no reason to expect they'll get worse as long as it stays under control.