RV Dilation and Systolic Dysfunction

[KimC]

Hi, again.

Thanks for helping me sort through this. I have my echo and cath report in hand.

Cath:

Coronary Flow Reserve was lower -- 2.4 (versus 2.6 in March). This is an indication of arterial stenosis. No large artery stenosis; the myocardial bridge has a mild systolic kink.

Echo:

LV, LA, RA, Aorta: normal
RV: mild dilation, mild systolic dysfunction
Mitral Valve: normal
Tricuspid Valve: mild insufficiency
Aortic Valve: moderate sclerosis with insufficiency

I spoke to my primary care doc who seems unconcerned. He wants to see me in his office next week. My cardio wants to see me in three months, continuing on all meds.

My question is ... WHAT is causing the right-sided heart failure, and should I be seeing my pulmo again? Is a right-heart cath indicated? Does mild tricuspid insufficiency cause mild RV dilation/dysfunction? (I thought only severe would, right?). Would an echo show pulmonary causes of RV failure?

Thanks.

Best,

 

[Nan]

Hi Kim, sorry I don't have any answers to your concerns, hopefully others will jump in....but just wanted you to know I was thinking about you and hoping that you will get this all resolved.

It is so hard not to have your questions answered. Any chance your cardio would see you earlier and would be amenable to answering your concerns? If you go in with a list?

Hang in there.

 

[Mary]

Kim,
I don't know that much, but your echo numbers look really good to me. If I had gotten echo results that looked like yours, I probably would have put my situation on the backburner, and not worried about having surgery for an extended amount of time.

When I had my heart caths (3) they did both sides--right and left.

I don't know if this helps or not, but maybe!
Mary

 

[Harrybaby666]

Kim, Did the doctor say anything about your....

Kim, Did the doctor say anything about your....

My question is ... WHAT is causing the right-sided heart failure, and should I be seeing my pulmo again? Is a right-heart cath indicated? Does mild tricuspid insufficiency cause mild RV dilation/dysfunction? (I thought only severe would, right?). Would an echo show pulmonary causes of RV failure?

Thanks.

Best,

Pulmonary Valves, Tricuspid Valves or check your Pulmonary Artery Pressure? I was told by my Cardiologist and my Pulmonologist that if a person has Secondary (Caused by another known issue) Pulmonary Hypertension, that it can and most likely cause Right-Sided Heart Failure. Right now, my Pulmonary Artery Pressure is at 43 which is in the mild range, but they check it regularly in case it goes higher. You might want to ask the Cardio what your Pulmonary Artery Pressure is, and consult with your Pulmonologist if the number is above 30. I hope this helps you. Take care, and I hope you are feeling better. Harrybaby

 

[KimC]

Thanks. I don't take my health for granted. I want an explanation for the RV dysfunction. Given that the valve disease isn't severe, it's more likely that small vessel or possibly pulmonary arterial stenosis is causing the changes.

My questions were not addressed by the interventional cardio who performed the cath. I won't see Dr. Pepine in person for another three months, and my local cardio is on vaca. I guess patience is a virtue.

I'm disappointed. I think my questions could've been addressed by a simple phone call. It's kinda like being told you're gonna lose your leg without anyone explaining why. Kinda.

Best,