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Severely Left atrial size


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  • Severely Left atrial size

    Hello everyone, I am new to this forum and I will like to ask the following: I was diagnosed with HCM 8 years ago and I had a defib insert in my heart 7 years ago, I had Vtach episodes and near syncope, but had never gone down until 1 month ago while playing basketball, my defib never went off and it did not record an abnormal arrhythmia. I went to the hospital the next day and did many test including an echo cardiogram, and the report reads " Asymetric septal hypertrophy is present, Normal left ventricular size and systolic with estimated EF of 65 to 70 %, severely increased left atrial size and moderately increased right atrial size. I already knew the septal findings but i never knew the enlargement of the atrium. Has anybody had something similar to this findings? and if so, what could you tell me about this? I feel good, I exercise at least 4 times a week and play sport as much as i can ( I will not be doing that anymore), If anybody have any information about this, I will appreciated. Thank you in advance for your help.

  • #2
    Hello Charles,
    THE most important thing you can do to insure a long healthy life with your HCM is to be evaluated fully at an HCM Center of Excellence. I believe both Stanford and UCLA/ Ronald Reagan Medical Center have HCM clinics with COE status. You can verify this with HCMA
    The extent of the thickness of your septum and the LVOT or left ventricular outflow tract pressures would also be important values on your echocardiogram report.
    In my experience, large left atriums in HCM are often caused by the stiffness of the left ventricle whether the size is changed or not. If the left ventricle is very stiff, blood from the left atrium cannot empty into the left ventricle in a normal fashion and it backs up increasing the size of the left atrium over time. If this continues, there can also be a back up of pressure into the lungs and into the right atrium, causing the right atrium to increase in size also.
    Large stretched out atriums are more prone to atrial fibrillation.
    Personally, I had moderately enlarged left and right atriums that returned to normal size, 1 year after the high pressures in my left ventricle were reduced by septal myectomy. Pressures can also be reduced with changes in medication.
    Have you been having a yearly echocardiogram and check up with an HCM specialist? Are you on medications?
    It sounds like a full work up and review of your case would be in order.
    Going to the hospital or ER addresses only the event that took place that sent you there. They do not address your long term needs as a person with HCM. I hope you will take the time to see an HCM specialist to get you on track for a better future.
    After years of symptoms:
    Officially Diagnosed HOCM 2006
    Myectomy 3/11/13 at non-COE
    Extended Myectomy 7/23/14
    At Mayo with Dr. Joseph Dearani


    • #3
      I agree with Jill; going to a COE seems essential.

      Let me add a point: arrhythmias aren't the only things likely to make us have syncope. Anything that decreases our blood pressure enough - especially in our brain - is likely to as well. In the population as a whole, the most common cause of fainting is what's called vasovagal (or neurocardiogenic) syncope -- an inappropriate response that causes the blood vessels in the legs to open wide, thus dropping the pressure in the brain. That's what causes soldiers standing at attention, or people after they've been frightened, to pass out. People with HCM can have this happen too, and it's much worse with HCM, because it greatly increases our gradients. I'm not suggesting that's what happened to you -- just that it's not all that rare for people to pass out due to other things, that an ICD won't help with those causes, and that you need to get assessed for those other causes because they can be real problems in people with HCM.

      Myectomy on Feb. 5, 2007.


      • #4

        Hi Jill,

        Thank you so much for your response, I want to apologize because I totally forgot that I had placed this text 2 years ago. Your information is very helpful. I looked into the center near me in California. I will be making coverage changes to try to get to one of them. I just got another echocardiogram and the atrium enlargement continues, now adding high pressure on my right ventricle. I will be seeing my cardiologist this friday. Everytime I come and see him, he tells me that everything is fine because I dont have any symptoms but then I see the changes ocurring with my heart and I do not know what to make of this. One big cloud over my head is that I had all of my 3 kids tested and all of them carry the same abnormal heart gen. I want to do everything I can to help them have a better outcome. I also want know as much as possible so I can help others as well. I will make sure to check back to any resposnses. have a wonderful day. Both Atrium are 5.4 cm/ EF 65/ RSVP 35.26mmHg/ RAP 10.00mmHg/, both ventricules are normal in size and function/ Septum is 2.4 cm non obstructive/ I exercise and lift weights, I am not able to do long period of cardio LVOT Vmax 0.80m/s / LVOT maxPG 2.58 mmHg LVOT diameter 2.2 cm.

        Hi Gfox,

        Thank you for your response as well. As of today, we never found out what cause that syncipe episode, but I do know that things are changing and that I will like to make informed decisions on what is next for me so I can help my family when I am no longer able to work or worse not being here. I trust in my Lord that what ever happens to me is His great plan, but I will like to do anything I can better my odds if possible and to leave a good road map for my kids if they ever develop the condition. Have a bless day.

        Carlos Marin


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