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Need Some help figuring out echo

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Amy N. Find out more about Amy N.
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  • Need Some help figuring out echo

    My 2 1/2 year old son had his annual check-up last week. Nothing new came out of the visit, but I still requested a copy of the echo. From the new echo, my son now has mild systolic anterior motion of the anterior leaflet of the mitral valve and has mild dynamic LV obstruction but no LVOT gradient. He also has a 89% ejection fraction.

    We've not had obstruction listed before. I know what SAM is pysically, but is there something I should be concerned about now that I know he has it? I know not having the LVOT gradient is good, but what about plain old obstruction, should I be more concerned now that he has it? Does a high ejection fraction mean anything?

    They also had IVSTD and IVSTS on the echo. What exactly is that?

    They doctor didn't share that he had obstruction. I guess I should have asked. We've had no problems and he's doing just fine. The info on the echo just wasn't what I expected.

    Thanks,
    Amy N.

  • #2
    Re: Need Some help figuring out echo

    Dear Amy,

    I'm so sorry no one replied to your post. Please read http://www.4hcm.org/phpBB2/viewtopic...highlight=echo for most of the abbreviations on an echo report. The post title is Echo Lingo if the link doesn't work for you.

    I don't recall what those two abbreviations you list mean, but you might be able to look them up elsewhere.

    The ejection fraction is good. Anything over 50% is good. This is the percent of blood that is getting out of the heart with each beat, so more is better.

    As for the SAM, the less the better. However, if there were any urgency, you would have heard about it. Also, the EF being high means that it can't be that bad.

    take care,

    s

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    • #3
      Re: Need Some help figuring out echo

      Amy, call your doctor back and ask for a more complete explanation. I think a key word here is
      dynamic
      . That means it is ever-changing, so he may not have felt he needed to mention it. However, he needs to explain that and what it means, also the other features and what they mean specifically for your child.
      Sarah, glad you caught this post. Sorry we all seemed to have missed it, Amy. Linda

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      • #4
        Re: Need Some help figuring out echo

        I am somewhat surprised by the comment that higher is better with respect to injection fraction. As I understand it, an injection fraction of 89% is excessively high, is clearly associated with HCM, and means that the heart is beating too strongly in order to accommodate for the irregularities in the heart muscle. This causes increased thickening of the heart muscle and may also cause symptoms as a result of deficiency of blood in the ventricle. As my cardiologist explained it to me, when the injection fraction gets over something around 70%, if an arrythmia hits the heart at the same time that the heart has just ejected too much blood, this can leave the heart muscle starved for blood and may cause fainting, pain, and other symptoms.

        I have been curious about a related question because my ejection fraction was measured in excess of 90% in May and was measured at 55% in July. I began taking beta blockers and calcium channel blockers during that time, so could that have made the difference?

        Rhoda from Beijing

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        • #5
          Re: Need Some help figuring out echo

          My bad --I had forgotten that "above 50% is normal" had a top end of normal.

          See http://www.acor.org/ped-onc/survivor...rdiotests.html
          and http://www.medhelp.org/perl6/cardio/archive/2845.html

          for more specifics.

          Yes, the betablockers surely got your EF down.

          s

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          • #6
            Re: Need Some help figuring out echo

            Thanks for the help, I appreciate it. I was wondering if the IVSTD & IVSTS could be measurements of the IVS in different spots? The number listed for his IVSTD 1.05 cm is really close to what was listed last year for his IVS Dias Thickness. I thought maybe the IVSTS could be a reading along the IVS closer to where you would see obstruction.???? I'll keep searching.

            Thanks,
            Amy N.

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            • #7
              Re: Need Some help figuring out echo

              they really ought to standardize the abbreviations.

              but i think you are right -I think it is IVS thickness diastolic and IVS thickness systole --the conditions of contracting and releasing (or the other way around, I always forget which is which).

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              • #8
                Re: Need Some help figuring out echo

                If that's correct, would the normals be the same no matter what your hearts doing (resting or contracting?) or are there different norms depending on which state?

                And I agree they should keep the info standard. It was the same facility that read his echo both years, but different hospitals performed the echos and different doctors read the echos. At least if it was standard, I'd know if I'm comparing the same info.

                Thanks,
                Amy N.

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                • #9
                  Re: Need Some help figuring out echo

                  i think t here is a small difference between the two since the muscle is flexing during the process. it helps them see what the heart does when it beats.

                  s

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                  • #10
                    Re: Need Some help figuring out echo

                    An EF of 89% is rather high. What is the doctor giving him at this time?

                    Lisa
                    Knowledge is power ... Stay informed!
                    YOU can make a difference - all you have to do is try!

                    Dx age 12 current age 46 and counting!
                    lost: 5 family members to HCM (SCD, Stroke, CHF)
                    Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
                    Therapy - ICD (implanted 97, 01, 04 and 11, medication
                    Currently not obstructed
                    Complications - unnecessary pacemaker and stroke (unrelated to each other)

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