Echoes and septum measurements

[Reinhard]

Does anybody know exactly where one has to measure the septum during an echo? Is it supposed to be at the thickest point or some specific point or area, perhaps near or below the valve? Is it averaged?

I ask this because this past Tuesday I had an echo done at my regular cardiologist as part of my ongoing monitoring of my HCM. At least this time I was a wee bit more knowledgeable on what to ask while I was being examined (thanks to this board).

One of the first items I inquired about was the thickness of my septum. I wanted to know the measurement was. The technologist stated 1.7. I found this quite interesting because I’ve had many echoes with many different measurements ranging from 1.6 to 3.0 (the 3.0 was measured at St Luke’s, NYC ) Quite a difference to say the least. The technician was very kind and showed me a picture of my septum which looked like something the Easter bunny left behind,………an egg. He stated that the docs usually want to measure the septum at a particular point which may not necessarily be at the thickest part, but probably at some point near the valve. He went on to say that the thickest part of my septum was probably around 3.0.

Since St’ Luke’s gave me the 3.0, I tend to believe them. (Based on that and a few other facts, I had an ICD implanted). I specifically remember Dr. Sherrid stating that they have a different approach to measuring the septum.

Any body else have similar experiences??

I’ll be getting the results of my recent echo shortly and I’ll go in armed with more questions for the docs.
Even though cardiologists know HCM and treat it, it appears that they don’t have a good grasp of it.

Reinhard

[Lisa Salberg]

Re: Echoes and septum measurements

The thickest point is what they tend to look for. You can have a measurement of 1.6 at the 'top' and it may be 3.0 a little lower and at the bottom it may be 1.3. It is very odd to see the wall the same number all around - but yes it can happen.

Lisa

[Reinhard]

Re: Echoes and septum measurements

Lisa

Thanks for the clarification. That's kinda what I thought.

I think it is a very important point, that individulas being diagnosed for hcm have an understanding of their echos so that they can disciuss their results intelligently with their doctor. After all 1.6 has a completely different ring that 3.0.

Just as you state................. "Knowledge is power....stay informed"

Reinhard

[Bert]

Re: Echoes and septum measurements

Lisa,

What do you mean by "it is odd to have the same numbers all the way around?" Do you mean for HCM people or people in general. Please advise.

Thanks
Bert

[kthanki]

Re: Echoes and septum measurements

Echo is basically an ultrasound technique of measurement. And the measurement depend on the person, on how and where transducer is placed on the chest. At what angle the heart and its walls are being look ed at.
The techs. try to keep their views standard for consistency e.g try ot make us sleep on the left, etc. This also gives a good view for the transducer.

Also, typcially in HCM the hypertrophy is assymetrical, so the idea is to measure the thickest portion.
I have measurements ranging from 1.9 to 2.6 cm. And during my trip to Mayo, the Dr. showed me how each measurement is possible. Basically, by placing the transducer in different ways, he was able to get 1.9, 2.2, 2.4 and 2.6cm. But the ultimate no. that counts is 2.6 since that will be the worst case scenario. Thats what I love about mayo, the first time in my HCM life of 20years, a Dr. came and did some of the measurements himself, and that is after Techs. did a detailed echo for 2hours vs. 20 minute job at my local cardiologitst.

[Lisa Salberg]

Re: Echoes and septum measurements

A normal heart has measurements that can vary slighlty that is why there is a "normal range" - In HCM the hypertrophy can vary also as to where it is located in the heart.
does this help?

Lisa

[Laura]

Re: Echoes and septum measurements

Wow thanks for the Info,
of all echos i have had, none of them are the same. When we went to boston World renowned EP dr pandian actually did part of the study and he measured 3.7. 6 months later a tech from Uof W measured it at 3.4.
and i have them ranging from 2.7-3.9 .
Odd really that there is no real precise locale.

Laura

[mongo_jones]

Re: Echoes and septum measurements

laura,

i used to think this was odd as well--when i was diagnosed a year ago i was told numbers from 2.6 to 3.7. the reason for the variation is that the thickening is rarely uniform. you may have greater thickening in some places than in others. in my case my latest measurements (at the excellent dr. shah's clinic in newport beach) suggest that my true range is 2.2 to 3.6. either way you slice it is pretty big! so i'm glad i got that icd. luckily for me the extreme thickening is so far not interfering with anything--my valve functioning is good--hopefully it will stay that way.

one earlier echo report had listed a maximal reading of 5 cm! i remember telling lisa about this on the phone and how it threw both of us (i am as yet mostly asymptomatic). dr. shah was intrigued to hear this as well and i'm glad to report he confirmed that this is not true at all. he said sometimes techs erroneously measure parts of the right ventricular septum and add it on. in everyone's defense echoes are an extremely dynamic way of measuring and will never give you an exact measure. for that i guess you need to have some catheters sent up your veins or maybe an mri (which for us cyborgs is not now in the range of possibility).

hope this helps a little.

regards,

mongo