My echocardiogram results

I am not looking for medical advice; I already have an appointment with a cardiologist.

I had an echocardiogram a few weeks ago, and I have a 3-page printout of the results. Here are the “Conclusions”:

*There is normal left ventricular systolic function.
There is concentric left ventricular hypertrophy.
Abnormal left ventricular diastolic filling is observed, consistent with impaired relaxation.
The left atrium is mild to moderately dilated.
There is mild aortic regurgitation.
There is moderate aortic stenosis.
The aortic valve area, by peak velocities, is calculated at 1.36 cm2.
There is a trace tricuspid regurgitation.
The right ventricular systolic pressure is calculated at 37 mmHg.
There is mild dilatation of the ascending aorta.
I’m 65 and diabetic. There is a family history of aortic valve needing replacement. So how much trouble am I in?

You have aortic stenosis (a narrowing of the heart valve through which blood exits the heart). The Wiki link for AS used to be excellent, now less so (guess who wrote the earliest versions ;))

Do you have symptoms such as fainting, angina (chest pain with exertion), or difficulty breathing (esp with exercise/activity)? Those are all cardinal symptoms of aortic stenosis. Usually, any of those symptoms in the presence of AS means surgery is indicated to replace the valve.

Further, even in the absence of symptoms, AS with a narrowing of of less than 1.0 cm[sup]2[/sup] also means surgery will usually be indicated to replace the valve.

Your valve area is now 1.36, so symptoms will be key. Regardless, you’ll need ongoing monitoring and follow-up.

Good luck! (Just a figure of speech; you’ll do fine. AS is pretty common and lots of surgeons have lots of experience with it).

I neglected to say that you also have some ‘incompetence’ or leaking of the aortic valve as well. This is called aortic regurgitation or aortic insufficiency and is a very common association of aortic stenosis (i.e. if the valve is damaged to the point of impeding blood flow out of the heart, it’s not surprising that it also leaks a bit and lets blood flow back into the heart - in the opposite direction of normal).

In terms of surgery, the status of your AS will dictate the options (i.e. aortic regurgitation is usually pretty well tolerated and usually pales in comparison to the importance of the AS)

All the other ECHO results are, IMHO, of little or no importance (or are normal) and are really just a reflection of the presence of the AS

Thanks, Karl. You’ve helped me put this in perspective.

I can’t improve on KarlGauss’s answers, but I’d like to comment on the “trouble” question.

If a patient’s primary problem is only a bad aortic valve, at worst the patient will need replacement. That’s a big deal but only in the sense that you need a new valve. The techology both for the valve itself and the replacement mechanism (minimally invasive surgery, for example) are spectacularly good, and so post-repair it’s fantastic how most patients do. You aren’t in nearly as much trouble as folks with non-fixable problems.

Associated coronary artery disease complicates the picture, but how much worse it makes it depends on the specifics of the blockages. Right now a patient with your echo results is showing a physiologically appropriate response to the higher pressures the heart needs to generate. The muscle is thickening because it’s working harder. You don’t want it to get too thick, and you don’t want it to start crapping out.

Your cardiologist will likely render an opinion on whether you should just be followed for symptom progression, or have a cardiac catheterization to evaluate things like measured gradients across the valve, valvular anatomy, and the state of your coronary arteries. Non-invasive testing is getting better and better, but sometimes the only way is to look.


Has anyone heard of a company that coordinates non-surgical aortic valve replacement for Americans in Europe? My dad is trying to find out and we’re both amatuers at this stuff!