[Gradients, enlargements etc.]

Author: Leon (---.lncstr01.pa.comcast.net)

Date: 10-24-02 16:56

HI folks. Spurred on by the proactive way people here seem to function I managed to get some of my records, but want to make sure I understand them. I got them from a nurse who seemed very busy and did not have the time to discuss them with me. I need your help. Here goes.

My septum is pretty big, almost 3cm. Luckily there is minimal obstruction. One comment reads "There is conserved left ventricular function." Any idea what that means?

"The right atrium is slightly enlarged." I assume that is a less than positive sign.

"There is mild aortic insufficiency and mild pulmonic insuffucuency." That can't be good.

"The mean pressurent gradient across the LV outflow track is only 4, peak flow is 7. With valsalva the mean gradient is only 7 with the peak of 11." The post PVC gradient is a mean of 11." Is this good, bad or just normal for HCM?

I would deeply appreciate any insight you god folks can give me on this, because I didn't have the chance to ask the cardiologist and the nurse was running around like a chicken without her head.

Thanks,

Leon

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[Re: Gradients, enlargements etc.]

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

Date: 10-24-02 18:08

Leon,

"There is conserved left ventricular function." Any idea what that means?

--I haven't seen this term used before.

"The right atrium is slightly enlarged." My reports don't list what the normal range is, so I can't tell you how big it too big, but being normal is always better. However, this happens in HCM and you just try and reduce the problems that can cause enlargement (arrhythmias mostly)

"There is mild aortic insufficiency and mild pulmonic insuffucuency." That can't be good.

--Mild is mild. We'll just try to keep it that way. Not a surprise with a septum of 3.

You pressure gradients were good, I'm pretty sure. Lisa can answer this one. I'm still not as up on these as I need to be (I'm working on it).

Are you seeing a specialist? If not, please call the office. With a septum so thick, you should be talking the best.

S

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[Re: Gradients, enlargements etc.]

Author: Linda (---.wmnsmd.adelphia.net)

Date: 10-24-02 18:49

Leon, Are you sure it wasn't "preserved" left vent function? Things get messed up with poor handwriting, dictation, and transcription. Just a thought, Linda

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[Re: Gradients, enlargements etc.]

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

Date: 10-24-02 19:49

I will add a few items... Nothing here looks odd...that is for HCM...with 1 exception..."The right atrium is slightly enlarged." it is normally the LEFT atrium that is slightly enlarged and ditto to what linda said..

Further the gradient is no big deal... the spetum of nearly 3, well that is on the larger side and with your family history...I think you should see the person we discussed for a 2nd opnion at this point.

Best wishes,

Lisa

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[Re: Gradients, enlargements etc.]

Author: Leon (---.lncstr01.pa.comcast.net)

Date: 10-24-02 22:58

Thanks Lisa and Sarah. How do I get to the Dr. for a 2nd opinion? Do I simply ask my regular cardiologist to make the referral?

Leon

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[Re: Gradients, enlargements etc.]

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

Date: 10-24-02 23:01

Dear Leon,

it depens on your insurance. Most HMOs require you to see a primary care physician and get the referral approved first. Most PPOs let you go see whoever you want, whenever you want. What you pay depends on if they are in or out of network.

So follow whatever instructions the insurance co. gives you so you can be sure to be covered. Then you can call the specialist and make the appt.

S

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[Re: Gradients, enlargements etc.]

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

Date: 10-25-02 08:06

check with your insurance..but remember you can always go for the 2nd... if your insurance does not pay that is a seperate issue... which you can always appeal..and with good cause you have a rare disease and you may be in need of a rather costly and serious option (ICD) it is in your and the insurance companies best interest to get a 2nd..

Lisa

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[Re: Gradients, enlargements etc.]

Author: Leon Miller (---.cap.east.verizon.net)

Date: 10-25-02 09:08

Hi Linda. I was reading from the echo tech's typed notes. My wife is a nurse and she had never seen that kind of reference either. Hopefully when I see the specialist he can tell me more. Thanks for your suggestion.

Leon

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[Re: Gradients, enlargements etc.]

Author: Leon Miller (---.cap.east.verizon.net)

Date: 10-25-02 10:29

Hi Lisa. Again thanks for your insight. I have cleared all the hurdles with the appropriate people and have a second opinion appointment set up with the Dr. you mentioned from Hershey Medical Center. That won't happen for another 3 weeks, but at least we have something lined up. Once again I appreciate all your helpful advice.

Leon

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[Re: Gradients, enlargements etc.]

Author: Lisa Salberg (208.47.172.---)

Date: 10-25-02 14:51

Glad to hear your on the right path!

all the best!

Lisa