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Heart Failure?
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RunHeart1 posted:
I have a question about my heart and if anyone had similar problems to mine. Have not seen a doctor yet to go over my results of some tests.
Background: I'm a 33 year old runner and 6 months ago I got a cold, at least I thought I did. I got better but my breathing while running got worse and how long I could run dropped. Sometimes becoming short of breath after 1-3 mins of running. My body would just shut down and I couldn't run.

I went to the doctor and had a BP of 164/114. Did EKG which showed no heart attack, or any rhythm problems but showed enlarged heart. She put me on Metoprolol 25mg and had me do a nuclear stress test 4 days later.

Results of test: Abnormal global wall motion with mild global hypokinesis, EF 45%, Abnormal EKG response to stress test, mild left ventricular dysfunction and mild left ventricular dilation.

After taking the Metoprolol I began to feel better and have been able to run with energy and no breathing problems. Based on the stress test I just had an Echo Doppler.
Findings: Normal left ventricular size and function EF 65%
Mild concentric left ventricular hypertrophy (from being a runner????)
Mild left atrial enlargement
LVPW thickness 1.1 cm
My EF went from 45% to 65% in 23days and the Echo showed no regional wall motion abnormalities. What conditions can improve that quickly? My PA said the only way I could improve my EF is if i had a heart attack or heart failure. Could I have been in heart failure during the last 6 months? Thanks for any replies.
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cardiostarusa1 responded:
Hi:

"Could I have been in heart failure during the last 6 months?"

It appeared so, as indicated by nuclear imaging.

And, in mentioning that you had caught a cold, or you thought you did, very noteworthy, some individuals, in various forums, have said that they, at first, had symptoms of a cold or the flu, and later discoverd that a virus affected their heart. Some viruses have what is known as "tissue affinity", that is, it homes in on/seeks out one or two types of body tissue. Coxsackie B goes for the heart muscle (myocardium) in which the virus locks onto receptor sites thereof.

Viruses/enteroviruses, which includes Coxsackie A and B can cause conditions such as myocarditis (inflammation of the muscle), which can lead to viral cardiomyopathy, heart muscle disease, which often leads to heart failure/congestive heart failure.

Dilated cardiomyopathy may/can be caused by an acute inflammation of the heart muscle (myocarditis) due to a viral infection, i.e., viral cardiomyopathy.

Understanding Your Ejection Fraction

http://my.clevelandclinic.org/heart/disorders/heartfailure/ejectionfraction.aspx


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To get a decent estimate of LVEF, a MUGA scan is reported as being the most accurate of the non-invasive methods.

Pertinent excerpt from an article - Richard N. Fogoros, M.D.

When is the MUGA scan more useful than other heart tests?

The advantages of the MUGA scan over other techniques (such as the echocardiogram) for measuring the LVEF are twofold
. First, the MUGA ejection fraction is highly accurate, probably more accurate than that obtained by any other technique. Second, The MUGA ejection fraction is highly reproducible. That is, if the LVEF measurement is repeated several times, nearly the same answer is always obtained. (With other tests, variations in the measured LVEF are much greater.)
.

As reported, as applicable to the patient, if/when the LVEF improves substantially or even recovers, and the heart appears to function near-normal or normally, other problems (unseen, that is, at a cellular or molecular level) often exist, or possible problems may/can occur anytime down the road, putting one at increased risk.

As reported, the normal thickness range of the LV is from 0.6 to 1.1 cm, measured at the very end of diastole (the heart's resting/relaxation phase). If more than 1.1 cm thick, a diagnosis of LVH can be made.

Several patterns of LVH have been described, such as concentric and eccentric. Concentric LVH is defined as an increase in LV thickness (all over) and LV mass with increased LV diastolic pressure and volume, commonly seen in those with high blood pressure (BP). As applicable, concentric LVH is a marker/indicator of poor prognosis in the presence of high BP

Causes of left atrial enlargement or dilation include, but is not limited to, mitral valve regurgitation (leakage, a backflow of blood through the one way-only valve) or stenosis (narrowing).
Also, LAE often occurs with any cause of left ventricular hypertrophy (LVH).

Health Central

Cardiac Enlargement: A Patient Guide

There are two types of cardiac enlargement: Hypertrophy and dilation....

With the exception of exercise-induced enlargement, all forms of cardiac enlargement are abnormal and associated with further......

http://www.healthcentral.com/heart-disease/patient-guide-44614-6.html

.

Best of luck down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)



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