Re: Echocardiogram Results

September 25, 2009

I went to my GP today and she told me the results of my Echo. Over here they don't give you the information on paper. I don't remember the exact results but I do have PH. I had mild to moderate something too. I went in for a lump on my leg that has to be watched. We talked about emphysema. She said that I might have emphysema as well as PF but she said that I went downhill too fast for just emphysema. She said that I went downhill PF fast. It seems like my new doctor ignored all of the testing that the other doctor dis and went by one CT scan. She suggested that maybe this new doctor isn't the doctor for me. She said that she got a nice letter from Dr. Raghu. He told her that he knew that she wanted the best for her patient. he said that he would go over the information that she sent him so he would be ready for me when I got there. It would be good not to have

PF but I do have it. I don't know what to do about this doctor. I hate changing again. I may just wait until after I see Dr. Raghu. If things get too bad I will change.I'm sorry that you have PH too. I got my results from my GP. When I got home I had a message from the pulmo's office. I will have to call tomorrow to see what, if anything, they are going to do about it. I'm sorry that I didn't have it all written down to compare with yours.Beverley Joy,71, UIP,NSIP 1-09,Diabetes,Sjogren's,Fibromyalgia IdahoSubject: Echocardiogram ResultsTo: "Breath Support" <Breathe-Support >Date: Friday, September 25, 2009, 5:42 PM

I received the results of my echo:

1. Left ventricular systolic function is preserved with estimated EF of

60%.

2. There is diastolic dysfunction.

3. There is mild left atrial enlargement

with trace mitral regurgitation.

4. There is a trace aortic

insufficiency without aortic stenosis.

5. There is mild tricuspid with

regurgitation.

6. There is mild-to-moderate

elevation of pulmonary artery pressure as described above. (Pulmonary Artery Systolic Pressure

(estimated): 45.0 mmHg)

7. There is no intracardiac mass, thrombus or pericardial effusion.

My pulmo doc said the diastolic dysfunction might be caused by my sleep apnea and should correct by using the CPAP. I've been using CPAP for about 3 months now. He is going to review my recordings. He referred me to a cardiologist for a cardiac catheterization test.Anyone have else have echo results like this? Comments? C_53_Familial IPF_5/09Washington

September 26, 2009

Hi Beverley,I have not been diagnosed with pulmonary hypertension and I hope I don't have it. I have a referral to see a cardiologist and most likely have the cardiac catherterization test.Glad you heard back from Dr. Raghu, I'm sure he will be able to resolve the emphysema and/or PF diagnosis. Make sure you provide him with your HRCT. C_53_Familial IPF_5/09WashingtonTo: Breathe-Support Sent: Friday, September 25, 2009 6:19:07 PMSubject: Re: Echocardiogram Results

I went to my GP today and she told me the results of my Echo. Over here they don't give you the information on paper. I don't remember the exact results but I do have PH. I had mild to moderate something too. I went in for a lump on my leg that has to be watched. We talked about emphysema. She said that I might have emphysema as well as PF but she said that I went downhill too fast for just emphysema. She said that I went downhill PF fast. It seems like my new doctor ignored all of the testing that the other doctor dis and went by one CT scan. She suggested that maybe this new doctor isn't the doctor for me. She said that she got a nice letter from

Dr. Raghu. He told her that he knew that she wanted the best for her patient. he said that he would go over the information that she sent him so he would be ready for me when I got there. It would be good not to have

PF but I do have it. I don't know what to do about this doctor. I hate changing again. I may just wait until after I see Dr. Raghu. If things get too bad I will change.I'm sorry that you have PH too. I got my results from my GP. When I got home I had a message from the pulmo's office. I will have to call tomorrow to see what, if anything, they are going to do about it. I'm sorry that I didn't have it all written down to compare with yours.Beverley Joy,71, UIP,NSIP 1-09,Diabetes, Sjogren's, Fibromyalgia IdahoFrom: worth <hope2thend (AT) yahoo (DOT) com>Subject: Echocardiogram ResultsTo: "Breath Support" <Breathe-Support@ yahoogroups. com>Date: Friday, September 25, 2009, 5:42 PM

I received the results of my echo:

1. Left ventricular systolic function is preserved with estimated EF of

60%.

2. There is diastolic dysfunction.

3. There is mild left atrial enlargement

with trace mitral regurgitation.

4. There is a trace aortic

insufficiency without aortic stenosis.

5. There is mild tricuspid with

regurgitation.

6. There is mild-to-moderate

elevation of pulmonary artery pressure as described above. (Pulmonary Artery Systolic Pressure

(estimated): 45.0 mmHg)

7. There is no intracardiac mass, thrombus or pericardial effusion.

My pulmo doc said the diastolic dysfunction might be caused by my sleep apnea and should correct by using the CPAP. I've been using CPAP for about 3 months now. He is going to review my recordings. He referred me to a cardiologist for a cardiac catheterization test.Anyone have else have echo results like this? Comments? C_53_Familial IPF_5/09Washington

September 26, 2009

Thanks Bruce for the insight and website! What do you think about the diastolic dysfunction? My pulmo doc thinks this is caused from sleep apnea and should be corrected with my CPAP use, but obviously hasn't. C_53_Familial IPF_5/09WashingtonTo: Breathe-Support Sent: Saturday, September 26, 2009 8:29:50 AMSubject: Re: Echocardiogram Results

Beth

I had a reading of 47 on the echo. Now the echo is maximum systolic

while the right heart catheter reads average diastolic pressure. The

echo is just a preliminary diagnosis tool in that and many other areas.

My echo led to right heart catheter, VQ, and Cardiac MRI. Now, 47 would

be considered high with 55 a serious reading. My right heart catheter

showed 18 with the normal range up to 25. So, conclusion, no PH.

I am scheduled for echo's every six months now and if there are other

indications or if my echo rises above 50 or up to 55 or so, then the

right heart catheter will be repeated.

We hear people talk about heart catheters so much it scares us a bit,

but the right heart catheter to check for PH is a very easy in and out

procedure. It's done through the neck with little risk. Yes there is

some risk as with anything. The only pain is them pricking you with a

very tiny needle several times to deaden the area. You are fully awake

and I got to watch it on the same monitor the doctor was observing. You

don't feel the catheter itself, just see them moving it around inside

you. The cardiologist didn't even wait to complete the procedure before

telling me my pressure was 18 so I was ok. No waiting for results, at

least in my case.

phassociation. org is a great website for anyone with questions or

wanting to learn more. It also is a source to locate doctors expert in

PH. Most doctors are not. If an echo indicates a potential problem they

should recommend a catheter. If the catheter indicates a problem, them

immediately get to someone expert in that field. Caught early, the

treatments can be effective for many people.

>

> ,

> I'm glad to hear you are going to see a cardiologist to get his/her

opinion of this reading of your echo. It's reassuring to see most if not

all the issues labeled as "mild" or "trace". The one area of concern is

the pressure and honestly even that is suspect without a right heart

cath. Pressure readings from echo's are estimates at best. I believe

Bruce had a similar reading on an echo recently and when they did the

cath his actual pressure reading was I believe at least 20 points lower.

>

> Please keep us posted about what the cardio says!

>

> Beth

> Moderator

> Fibrotic NSIP 06/06 Dermatomyositis 11/08

>

> ____________ _________ _________ __

> From: worth hope2thend@. ..

> To: Breath Support Breathe-Support@ yahoogroups. com

> Sent: Friday, September 25, 2009 8:42:24 PM

> Subject: Echocardiogram Results

>

> I received the results of my echo:

>

> 1. Left ventricular systolic function is preserved with estimated EF

of 60%.

> 2. There is diastolic dysfunction.

> 3. There is mildleft atrial enlargement with trace mitral

regurgitation.

> 4. There is a traceaortic insufficiency without aortic stenosis.

> 5. There is mild tricuspid with regurgitation.

> 6. There is mild-to-moderateele vation of pulmonary artery pressure as

described above. (Pulmonary Artery Systolic Pressure

(estimated): 45.0 mmHg)

> 7. There is no intracardiac mass, thrombus or pericardial effusion.

>

> My pulmo doc said the diastolic dysfunction might be caused by my

sleep apnea and should correct by using the CPAP. I've been using CPAP

for about 3 months now. He is going to review my recordings. He

referred me to a cardiologist for a cardiac catheterization test.

>

> Anyone have else have echo results like this? Comments?

>

> C_53_Familial IPF_5/09

> Washington

>

September 26, 2009

Me again BJ... I'm sorry to read about the PH and the 'mild to moderate something' too. Good news that the lump will be watched.

I'll sure try and encourage you to find a new Dr. Especially at the urging of your GP. I do know how tiring it is to seek out a new Dr. In fact, I just did and will see him on Monday regarding the side effects of a bladder infection (that I'm thinking is not totally cured).

Let's do what we can while we are stronger than wait until we are weaker. Get the best care we can find and have it in place for the 'rainy days'.

I'm not absolutely thrilled with my pulmodude but I know he gives me good care. He just doesn't have the 'bedside manner' I would like. I'm anxious to see Dr. Raghu and get his information.

Let's keep on keepin' on...

MamaSher; 71, IPF 3-2006, OR.Don't fret about tomorrow, God is already there!

Re: Echocardiogram R

September 26, 2009

... I missed something someplace. WHAT is caused by your cpap?

I too use cpap...curious. thanks

MamaSher; 71, IPF 3-2006, OR.Don't fret about tomorrow, God is already there!

Echocardiogram Results>>> I received the results of my echo:>> 1. Left ventricular systolic function is preserved with estimated EFof 60%.> 2. There is diastolic dysfunction.> 3. There is mildleft atrial enlargement with trace mitralregurgitation.> 4. There is a traceaortic insufficiency without aortic stenosis.> 5. There is mild tricuspid with regurgitation.> 6. There is mild-to-moderateele vation of pulmonary artery pressure asdescribed above. (Pulmonary Artery Systolic Pressure(estimated): 45.0 mmHg)> 7. There is no intracardiac mass, thrombus or pericardial effusion.>> My pulmo doc said the diastolic dysfunction might be caused by mysleep apnea and should correct by using the CPAP. I've been using CPAPfor about 3 months now. He is going to review my recordings. Hereferred me to a cardiologist for a cardiac catheterization test.>> Anyone have else have echo results like this? Comments?>>> C_53_Familial IPF_5/09> Washington>

September 26, 2009

Thanks Beth,At first I was kind of alarmed at the list of results, but then I noticed "mild and trace" but my pulmo doc didn't seem to worried, but was concerned enough to have me further evaluated. He also mentioned that the pressure rating is an estimate and would most likely be much lower during the catheter test, so that's good too. C_53_Familial IPF_5/09WashingtonTo: Breathe-Support Sent: Saturday, September 26, 2009 7:21:41 AMSubject: Re: Echocardiogram Results

,

I'm glad to hear you are going to see a cardiologist to get his/her opinion of this reading of your echo. It's reassuring to see most if not all the issues labeled as "mild" or "trace". The one area of concern is the pressure and honestly even that is suspect without a right heart cath. Pressure readings from echo's are estimates at best. I believe Bruce had a similar reading on an echo recently and when they did the cath his actual pressure reading was I believe at least 20 points lower.

Please keep us posted about what the cardio says!

Beth

Moderator

Fibrotic NSIP 06/06 Dermatomyositis 11/08

From: worth <hope2thend (AT) yahoo (DOT) com>To: Breath Support <Breathe-Support@ yahoogroups. com>Sent: Friday, September 25, 2009 8:42:24 PMSubject: Echocardiogram Results

I received the results of my echo:

1. Left ventricular systolic function is preserved with estimated EF of 60%.2. There is diastolic dysfunction.3. There is mild left atrial enlargement with trace mitral regurgitation.4. There is a trace aortic insufficiency without aortic stenosis.5. There is mild tricuspid with regurgitation.6. There is mild-to-moderate elevation of pulmonary artery pressure as described above. (Pulmonary Artery Systolic Pressure (estimated): 45.0 mmHg)7. There is no intracardiac mass, thrombus or pericardial effusion.My pulmo doc said the diastolic dysfunction might be caused by my sleep apnea and should correct by using the CPAP. I've been using CPAP for about 3 months now. He is going to review my

recordings. He referred me to a cardiologist for a cardiac catheterization test.Anyone have else have echo results like this? Comments?

C_53_Familial IPF_5/09Washington

September 26, 2009

I think in our situations echo's tend to show a lot of atypical things

that only a doctor with the right expertise can evaluated based on other

things. I recall there are one or two doctors at UWMC with PH expertise.

I suspect they may even want to follow up with a cardiac MRI. I'm sure

the thing of primary concern first though is the heart catheter. The

cardiologist who performs that may well gain insight into some of the

other matters at the same time. Mine did indicate some of my issues like

severely dilated right ventricle were things he often saw on PF'ers

echos. So ultimately what does mine mean? There are some signs on the

right side of my heart that probably reflect lack of oxygen and wouldn't

be seen in a normal healthy person. However, there isn't PH nor is there

anything else to cause significant concern today. But, regular

monitoring will continue. I hope yours turns out much the same.

> >

> > ,

> > I'm glad to hear you are going to see a cardiologist to get his/her

> opinion of this reading of your echo. It's reassuring to see most if

not

> all the issues labeled as " mild " or " trace " . The one area of concern

is

> the pressure and honestly even that is suspect without a right heart

> cath. Pressure readings from echo's are estimates at best. I believe

> Bruce had a similar reading on an echo recently and when they did the

> cath his actual pressure reading was I believe at least 20 points

lower.

> >

> > Please keep us posted about what the cardio says!

> >

> > Beth

> > Moderator

> > Fibrotic NSIP 06/06 Dermatomyositis 11/08

> >

> > ____________ _________ _________ __

> > From: worth hope2thend@ ..

> > To: Breath Support Breathe-Support@ yahoogroups. com

> > Sent: Friday, September 25, 2009 8:42:24 PM

> > Subject: Echocardiogram Results

> >

> > I received the results of my echo:

> >

> > 1. Left ventricular systolic function is preserved with estimated EF

> of 60%.

> > 2. There is diastolic dysfunction.

> > 3. There is mildleft atrial enlargement with trace mitral

> regurgitation.

> > 4. There is a traceaortic insufficiency without aortic stenosis.

> > 5. There is mild tricuspid with regurgitation.

> > 6. There is mild-to-moderateele vation of pulmonary artery pressure

as

> described above. (Pulmonary Artery Systolic Pressure

> (estimated): 45.0 mmHg)

> > 7. There is no intracardiac mass, thrombus or pericardial effusion.

> >

> > My pulmo doc said the diastolic dysfunction might be caused by my

> sleep apnea and should correct by using the CPAP. I've been using CPAP

> for about 3 months now. He is going to review my recordings. He

> referred me to a cardiologist for a cardiac catheterization test.

> >

> > Anyone have else have echo results like this? Comments?

> >

> > C_53_Familial IPF_5/09

> > Washington

> >

>

September 26, 2009

Limits of Echocardiogram:

Basically the best way for us to think of it is as a test to determine

if other tests might be appropriate. It can indicate issues, but its not

generally definitive on many things. It's our first line of defense and

essential that all of us have them regularly. I'm now on a six month

schedule but I would say that as a PF'er I would never have them less

frequently than once a year, even if they look perfect. The PFT's, the

CT's the six minute walks all typically are going to tell you things you

already know from your oxygen usage and watching your saturations. The

echo can warn you of things that otherwise you wouldn't know.

I think sadly of Lou who was hit with severe PH near the end. She

had been three years without an echo which might have warned and allowed

earlier treatment. We recognized the signs of PH when she told us her

symptoms and then she went to the doctor. But by the time the symptoms

are that severe its far more difficult to treat. What if she'd gotten

Revatio or Tracleer a year or two earlier? We'll never know. I just know

echos are critical for PF'ers.

>

> Thanks Beth,

> At first I was kind of alarmed at the list of results, but then I

noticed " mild and trace " but my pulmo doc didn't seem to worried, but

was concerned enough to have me further evaluated. He also mentioned

that the pressure rating is an estimate and would most likely be much

lower during the catheter test, so that's good too.

>

> C_53_Familial IPF_5/09

> Washington

>

> ________________________________

> From: Beth mbmurtha@...

> To: Breathe-Support

> Sent: Saturday, September 26, 2009 7:21:41 AM

> Subject: Re: Echocardiogram Results

>

> ,

> I'm glad to hear you are going to see a cardiologist to get his/her

opinion of this reading of your echo. It's reassuring to see most if not

all the issues labeled as " mild " or " trace " . The one area of concern is

the pressure and honestly even that is suspect without a right heart

cath. Pressure readings from echo's are estimates at best. I believe

Bruce had a similar reading on an echo recently and when they did the

cath his actual pressure reading was I believe at least 20 points lower.

>

> Please keep us posted about what the cardio says!

>

> Beth

> Moderator

> Fibrotic NSIP 06/06 Dermatomyositis 11/08

>

> ________________________________

> From: worth hope2thend (AT) yahoo (DOT) com>

> To: Breath Support <Breathe-Support@ yahoogroups. com>

> Sent: Friday, September 25, 2009 8:42:24 PM

> Subject: Echocardiogram Results

>

> I received the results of my echo:

>

> 1. Left ventricular systolic function is preserved with estimated EF

of 60%.

> 2. There is diastolic dysfunction.

> 3. There is mildleft atrial enlargement with trace mitral

regurgitation.

> 4. There is a traceaortic insufficiency without aortic stenosis.

> 5. There is mild tricuspid with regurgitation.

> 6. There is mild-to-moderateelevation of pulmonary artery pressure as

described above. (Pulmonary Artery Systolic Pressure

(estimated): 45.0 mmHg)

> 7. There is no intracardiac mass, thrombus or pericardial effusion.

>

> My pulmo doc said the diastolic dysfunction might be caused by my

sleep apnea and should correct by using the CPAP. I've been using CPAP

for about 3 months now. He is going to review my recordings. He

referred me to a cardiologist for a cardiac catheterization test.

>

> Anyone have else have echo results like this? Comments?

>

> C_53_Familial IPF_5/09

> Washington

>

September 26, 2009

Thanks Bruce. My primary pulmo care is with Group Health, so I'll be seen by one of their cardiologists, hope he knows something about PF too. Of course, when I go back to see Dr. Raghu, he'll review all of my tests and procedures and make his recommendations too. C_53_Familial IPF_5/09WashingtonTo: Breathe-Support Sent: Saturday, September 26, 2009 10:44:45 AMSubject: Re: Echocardiogram Results