Confused!!!

[hismom]

Hey again Guys,
Lisa I will be calling before the end of the week. I desperately need to speak with you about a few things happening here with our son.

I received some paperwork from the doctor that I have to mail to my son's father in Korea. He is stationed there and the base he is on doesn't feel it necessary enough for him to be TESTED and he is trying to get to a different base for an appointment. he is also trying to get back stateside. Anyway~ the paper says this

Electrocardiogram demonstrates a normal sinus rythym with normal axis and intervals and normal QTC. Echocardiogram reveals a normally-related great vessels and chambers with septal hypertrophy most predominantly in the subaortic area. (His is blocking the LV aorta). There is moderate subaortic stenosis with a peak gradient of around 50mmHg.
The cardiac function is somewhat hyperdynamic with an ejection fraction of 77%. Ok that is what I need explained to me. Please can you guys help me understand what all that means? I appreciate the responses in advance you guys are the greatest!!! Take care!

[Pat]

Hi, hismom! I hope I can help with the basics; I'm sure Lisa can fill in with more specific info related to your son's particular situation.

"Electrocardiogram demonstrates a normal sinus rythym with normal axis and intervals and normal QTC." This means that the electrical conduction in his heart is normal--the impulses get to his cardiac muscle in the usual way.
"Echocardiogram reveals a normally-related great vessels and chambers" means the large blood vessels which lead into the atria and out of the ventricles of the heart are normal and that all four chambers (atria and ventricles) of his heart are normal.
"with septal hypertrophy most predominantly in the subaortic area. (His is blocking the LV aorta)." This means that the muscular wall between the two ventricles (the septum) is overgrown or enlarged. The bulge from this enlargement acts as a partial block to blood flow from the left ventricle into the aorta. This is what HCMers know as obstruction.
"There is moderate subaortic stenosis with a peak gradient of around 50mmHg." This means there is a constriction & rigidity in the area of the obstruction--which is just below the aorta. And at the moment the left ventricle reaches its greatest contraction, the blood pressure in the ventricle is 50mmHg higher then the pressure in the aorta. (Think of having your blood pressure taken. When it is 120/70, there is a 50mmHg difference between the pressure when the ventricles contract and the pressure when the ventricles relax.)
"The cardiac function is somewhat hyperdynamic with an ejection fraction of 77%." The heart is working harder than a normal heart would (because of the obstruction, I'd expect). 77% of the blood in the left ventricle is forced out into the aorta with each contraction--this is within the range of normal or desireable.

Normally there is no pressure gradient between the left ventricle and the aorta. The reason your son has the gradient is because of that obstruction which narrows the opening. It helps me to think of water flowing through a pinched hose to visualize what is happening with this obstruction. His heart is working hard to get the blood around the body. It has suffered no further damage from this effort.

The issue becomes relaxing the heart some and reducing the obstruction if possible. The drugs you read about on this site, especially beta-blockers and calcium channel blockers, can be very effective in doing this.

Please let me know if this is helpful--I can get very involved in my explanations of things and leave folks confused!

Good luck,
Pat

[hismom]

Thanks Pat! That was actually very helpful and relieving. Essentially he is doing well over all considering he has HCM. I know it may not always be that way but at least for now it is! He was on a beta blocker that we had to step him down off of due to horrible nightmares and the doc he is seeing has left him unmedicated till we return on the 28th of the month. I will kepp you guys updated. Thanks again!

[Lisa Salberg]

In short... HCM with obstruction that is what is says to me.. call me Thursday.
Lisa

[hismom]

Lisa I apologize for not being able to call yesterday. We were in the doctor most of the day with my husband. He has caught the crud I just got over. I think it is making it's way around the country. Anyway~ I know you are extremely busy so just let me know a good time to call and I will. I am going to be home all day today (Friday) so if today is good I'll call. If not I will wait. Thanks again!

[Lisa Salberg]

Saturday at noon time I should be in the office...as long as it is not snowing too bad here ...
oh did I mention that in 2 weeks I am going to FLORIDA!!!!!!!!!!!!!!!!!!!!

Lisa

[hismom]

I'll check the news for snow up that way and then call!! I like Florida too by the way. I am a tried and true waterbaby/ sunlover. I do like the snow though. Only cause it is truly an act of God when it snows here in LA (lower alabama) And of course we get an inch and we shut down. Stay warm Lisa and I'll talk to you soon. Thanks!