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  • normal values

    [normal values]

    Author: vickie (---.jacksonville.net)

    Date: 02-15-02 16:26

    Can anyone tell me what normal values are for ventricular septum measurements, gradients, and velocity? I recently had an echo (the first one since I was diagnosed with HOCM 1 1/2 years ago). There were some slight improvements on the second echo. I am on Norpace 600 and Atenolol 100 mg per day. I guess the meds are responsible for the improvements but I was under the opinion that the septal size would not reduce without surgery. I still feel crummy although I have much less pain than I did before starting meds. Has anyone else had improvements in their numbers but still feel bad and frustrated that this is as good as its gonna get? Thanks.

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    [Re: normal values]

    Author: Bob (---.dyn.optonline.net)

    Date: 02-21-02 16:14

    Hi Vickie,

    My understanding is that normal thickness is less than 13 mm. A small change on one echo could just be within the the normal range of measurement error, but it's certainly better than seeing an increase. LVOT pressure gradient theoretically should be 0 mm Hg, but anything less than 30 mm Hg is not considered a major issue.

    Bob

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    [Re: normal values]

    Author: beckley (---.dsl.mindspring.com)

    Date: 02-24-02 06:07

    Dear Vickie

    Welcome.

    There is some reseach that indicates that beta-blockers (atenolol) sometimes reduces the hypertrophy, but -as you are aware- that doesn't mean you are going to feel better. My mother's hypertrophy reverted, and I have had some improvement as well. But we are both fully medicated and still symptomatic.

    The problem with the hypertrophy is that the electrical system doesn't get fixed just by having the muscle go down a little bit. If you read the HCMA overview on HCM, you'll see the info about the disorganized muscle cells and their role in the disease.

    When people have ablations and myectomys, the disorganized cells are killed or removed.

    Take care,

    Sarah

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    [Re: normal values]

    Author: lisa (208.47.172.---)

    Date: 03-04-02 14:12

    Hi,

    Slight correction-

    1. Beta Blockers are not ment to reduce hypertrophy.

    2. Ablations and myectomy do not "kill disorganized" cells, they remove the portion of the septal wall that interferes with the outflow of blood from the left ventricle. They reduce "SAM" systolic anterior motion caused when the mitral valve "hits" the septal wall.

    Best wishes,

    Lisa

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    [Re: normal values]

    Author: ch (---.nas48.philadelphia1.pa.us.da.qwest.n)

    Date: 03-18-02 12:33

    I read online that 50 LVOT to 80 is considered severe. I am at 49.13 and wondering how treatment changes after the 50 LVOT gradient?

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    [Re: normal values]

    Author: sarah beckley (---.dialup.mindspring.com)

    Date: 03-18-02 15:05

    Dear CH

    I don't think there are hard and fast rules on a particular treatment for a particular number. Have you talked to your doctor about this? How are you feeling? Your treatment should be appropriate to your symptoms and needs. I'll see if I can find anything out for you.

    Take care,

    Sarah

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    [Re: normal values]

    Author: CH (---.nas48.philadelphia1.pa.us.da.qwest.n)

    Date: 03-19-02 09:12

    Thanks Sarah,

    I had an echo done last week, but wont see the card for another week (that kinda thing drives me crazy). But, I did notice during the echo, that the LVOT number was higher. Symptoms are fairly rare and mild. I hate the waiting.

    Thanks again.

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: normal values]

    Author: sarah beckley (---.dialup.mindspring.com)

    Date: 03-19-02 10:51

    Dear CH

    Hey, at least you feel ok! But I know how you feel. I have an e-mail into the head office about treatment and will let you know what they say.

    take care and let us know what the cardiologist says.

    Sarah

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    [Re: normal values]

    Author: Bob (---.dyn.optonline.net)

    Date: 03-24-02 21:04

    Vickie,

    My basal (resting) LVOT gadient reached 140mm before my recent dual-chamber pacer implant, even though I still had no symptoms; thus the Doc's were reluctant to go beyond treatment with beta blockers. Apparently the accepted treatment modalities all are based on relieving symptoms, since no cures for HCM have been found. I found this somewhat disturbing, because a high gradient does forecast a poorer outcome. When it was recently determined I needed a defibrillator, the Doc's agreed to include one that provided dual-chamber pacing, which historically has had various levels of success. I got the device 5 days ago and the gradient immediately fell to 50 mm. They believe further reduction may occur through "tuning" the device once I have healed, and some long term changes to the heart which frequently occur. I am very happy with the results - at least it's moving in the right direction for a change. If you have any other questions don't hesitate to ask me.

    Bob

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    [Re: normal values]

    Author: CH (---.nas48.philadelphia1.pa.us.da.qwest.n)

    Date: 03-27-02 13:37

    Sarah,

    Just got back from the card. I received pre-op clearance, but the doctor did say I should be hospitalized to be monitored overnight after the surgery. (The surgeon had scheduled it as an outpatient procedure.) In a way, I am kind of glad, when I last had out-patient surgery under general anesthesia, I was very ill for a few days.

    As for the gradient, I must have misunderstood the gradient level, or had gotten the wrong one. He said my gradient was at 100. When I last had surgery, it was at 120, but I had a lot of symptoms then. This was not my regular cardiologist, but he did suggest watching the results of alcohol abalation (sp?) studies for future information. Like someone else here suggested, symptoms must be a key factor.

    CH

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    [Re: normal values]

    Author: sarah beckley (---.dsl.mindspring.com)

    Date: 03-27-02 14:45

    Dear CH

    What are you having done? I don't think you mentioned surgery before now.

    I'm glad you are staying overnight too, that is much better.

    Alcohol ablation is a technique where they inject alcholol into the hypertrophy. THere are several other procedures for HCM as well.

    I recommend joining the HCMA so you have access to the latest info on this stuff. You can also do a lot of research on-line. www.google.com is a great search engine. The HCMA can also give you the names of any HCM specialists in your area, and it sounds like you really need to see someone who knows what they are talking about.

    good luck and write back after your procedure,

    S

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    [Re: normal values]

    Author: ch (---.nas48.philadelphia1.pa.us.da.qwest.n)

    Date: 04-12-02 05:40

    Sarah,

    I had surgery on Monday to remove internal sutures (absorbable in most people) that calcified and made their way to the surface, causing the old scar to open and become infected. The original surgery was open heart surgery done in the 1970s when I was a child.

    The surgery itself seems to have gone well, but one of the complications mentioned by the cardio did occur. My blood pressure dropped very low in reaction to the anethesia. At one point, I remember it being 70 over 38, but I think it may have be lower earlier on. The gave me meds to get the blood pressure up and weaned me off it slowly. I was also vomiting all night the first night -- a result of anesthesia also possibly. I have limits for another week or so, but am glad to be home.

    I see my regular cardiologist in a few weeks for a check up.

    Thanks for your responses. I will check into HCMA. Thanks for the suggestion.

    ch

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    [Re: normal values]

    Author: Sarah Beckley (---.dsl.mindspring.com)

    Date: 04-12-02 07:58

    Dear CH

    I'm glad you are recovering after such an ordeal. I think you will find the HCMA very helpful.

    take care and best wishes,

    Sarah
    NOTE: This is a post from the previous forum message board.

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