[Measurement of the septal]

Author: Pat H (---.proxy.aol.com)

Date: 09-10-02 16:48

Could you please address which measurement should be used? I have seen mm and cm. I think there is 10 mm for each cm. but I’m not sure. What other areas when having an echo would you want a measurement for?

Thanks to the HCMA staff and members for helping me understand that I'm not alone.

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[Re: Measurement of the septal]

Author: Sarah B--Board Moderator (---.client.attbi.com)

Date: 09-10-02 18:01

Dear Pat

There are ten milimeters in a centimeter. Centimeters are used most often, but it makes no difference as long you don't confuse the cm and the mm. (so 17mm is 1.7cm, 30mm = 3.0cm, etc)

An echo report measures the size of the atria, the ventricles and the outside walls, too. There are average ranges for all of them. (they are usually listed on the echo report alongside your result.)

Glad to know I'm helping.

S

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[Re: Measurement of the septal]

Author: Pat H (---.proxy.aol.com)

Date: 09-10-02 23:50

Just want to make sure I understand right. The septal measurement should be under 3.0cm? My is 14mm or 1.4cm which would be under the 3.0 that is a concern?

Thanks for the help. The doctors have not explain any measurement or what they mean. I had to get the reports to see any of the measurements, so I'm trying to understand what is listed on them.

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[Re: Measurement of the septal]

Author: Sarah B--Board Moderator (---.client.attbi.com)

Date: 09-10-02 23:52

Dear Pat

Your interpretation is correct. 3.0 cm is the borderline for considering an ICD.

1.4 is not so bad, all things considered.

take care,

S

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[Re: Measurement of the septal]

Author: Reenie Smith (---.snbrca.adelphia.net)

Date: 09-10-02 23:55

No, the septal measurement doesn't have to be under 3.0 cm. Normal is under 1.2 cm if I'm not mistaken. Everyone varies some. And some people with less thickening have more symptoms than people with more thickening. Like I said, the disease is very variable from person to person, even within families. But some people can get measurements over 3.0 cm. My husband is one of these people and his only symptoms are some shortness of breath upon exertion and occasional palpitations. He's not necessarily the norm. Again, everyone is different. Please take that into consideration.

Reenie

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[Re: Measurement of the septal]

Author: Reenie Smith (---.snbrca.adelphia.net)

Date: 09-10-02 23:57

Sorry Sarah. Guess we were posting at the same time.

Reenie

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[Re: Measurement of the septal]

Author: Sarah B--Board Moderator (---.client.attbi.com)

Date: 09-11-02 00:18

Dear Reenie,

No, your answer was good too, 1.4 is not normal, but it isn't in "ICD-land" either. And I should have been clearer about that.

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[Re: Measurement of the septal]

Author: Dolly W (---.proxy.aol.com)

Date: 09-11-02 11:07

So, Sarah,

What would be septal measurement for "ICD-land"?

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[Re: Measurement of the septal]

Author: Julie (---.proxy.aol.com)

Date: 09-11-02 11:28

I made it to ICD land with a 2.2 septal thickness. But then I also have a family history of SCD when my brother died from cardiac arrest at 37.

To be honest the shocks are not the most pleasant thing but I'm glad I have it!

Julie

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[Re: Measurement of the septal]

Author: Sarah B--Board Moderator (---.client.attbi.com)

Date: 09-11-02 12:31

Dear Dolly,

In that post you refer to, I was thinking specifically of the guideline that says septal walls over 3 cm are a risk factor. However, as Julie point out above, it is never black and white. Here is my post from another thread that explains a little bit more about weighing the risk factors...

Re: Important Infomation Needed!

Author: Sarah B--Board Moderator (---.client.attbi.com)

Date: 09-10-02 19:45

Dear Amy,

As Reenie mentioned, extereme hypertrophy alone is going to get you an ICD --anything over 3cm is worth serious consideration.

Enough episodes of vtach are going to get you an ICD, too, as will a lot of sudden death in the family.

While most doctors will want to see 2 or more of the 5 known risk factors (all of the above plus fainting and blood pressure problems in a stress test), if any one of them is "big" enough (aka often enough or serious enough), that will do.

Also, you have to understand that the statistics out there about sudden death are skewed too high from overreporting from the main centers and little to no reporting from regular hospitals of milder cases. So the actual stats on sudden death are closer to 1 or 2 percent of the whole population. Not enough to warrant sticking ICDs in all of us just in case.

Hope this answers your question.

In Julie's case, her family history was strong enough to push her over edge even though her septum was not 3cm. I'm guessing that she probably had some vtach too, ---Julie?

S

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[Re: Measurement of the septal]

Author: Lisa Salberg (---.dyn.optonline.net)

Date: 09-12-02 19:33

My turn...

ICD's are not detirmined on measurement alone... those with lower spetal measurements can be at risk...3.0 is simply a risk factor on its own.

This will be addressed on the updated site.

lisa

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[Re: Measurement of the septal]

Author: Sarah B.-Board Moderator (---.client.attbi.com)

Date: 09-13-02 03:59

Dear lisa

Thanks for saying clearly what i was trying to say the long way.

S

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[Re: Measurement of the septal]

Author: robin (---.tnt4.winston-salem.nc.da.uu.net)

Date: 09-18-02 05:01

Hi

Thanks for yoru post on thie GRAT site!

I am new to "HCM Land" and am trying to learn as much as quickly as possible.

I had a cardio catherization about 10 days ago which revealed the thickening of the wall.

My cardiologist mentioned that I may be referred to a specialist for ICD consideration after my follow-up visit on the 25th.

He did not say how much thickening I have. I am a bit confused about what "qualifies" me for an ICD.

I have a STRONG family history and I have no idea what V-Tachs are so I don;'t know about that.

I have GREAT blood pressure levels.

Can you shed any light on any fo this?

Thanks,

Robin

winston-salem, NC

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[Re: Measurement of the septal]

Author: Sarah B.-Board Moderator (---.client.attbi.com)

Date: 09-18-02 12:32

Dear Robin,

Sudden Death Risk factors:

Family history of early/sudden death with HCM.

personal History of cardiac arrest

personal History of arrthymia - VT or repeat NSVT

Mass hypertrophy - septal measurement of 3.0 or greater

Adverse blood pressure responce on stress test

Fainting/passing out -repetitive - (careful to evaluate for obstruction)

NOT RISK FACTORS AT THIS TIME:

Obstruction

If your doctor suspects you need an ICD, it is not something you wait around for.

Also, as for weighing the risk factors, everyone is different and variations have to be taken into account. For example, if you had a septal wall measurement less than 3 but lots of vtach, you would probably get the ICD. If you didn't have any symptoms but your family history was very, very bad, a couple times people have gotten an ICD based on that alone. Or if their septum was just huge but not too many other factors. So it is CRITICAL that you see an HCM specialist to make sure you are evaluated properly.

take care,

S

PS calling the office will get you hooked up with a specialist.