How Often Should You Get a Heart Ultrasound? Your Reports

Q: How Often Should You Get a Heart Ultrasound? Your Reports

Hello, follow-up should be done at most once a year; it should be a measurement error. <br>A difference of two months is significant. <br>Undergoing valve surgery will not eliminate premature beats, and no one undergoes surgery for such mild issues. <br>Valve repair surgery does

How often should a cardiac ultrasound be performed (and how to interpret the cardiac ultrasound report)?

Hello, Doctor.
I have two echocardiogram reports that are about two months apart.

1.
In one of the reports, the LAD (19-40mm): 43.
Does this indicate left atrial enlargement? Is it serious? I have concerns because I have premature beats and mitral valve prolapse.

2.
If I have premature beats and mild mitral valve prolapse, how often should I have an echocardiogram for health checks?
3.
Why do the two reports show one with normal left atrial size and the other indicating it is enlarged (the left ventricle as well)? Is this due to measurement variability? Is it possible for such significant changes to occur in just two months?
4.
I underwent a coronary CT scan, and all three major coronary arteries showed no calcification or blockage; they are clear.
There is mild myocardial bridge but not deep, and I have mitral valve prolapse.
If I undergo valve surgery, will the premature beats disappear? The doctor mentioned that the premature beats might be caused by mitral valve prolapse (mitral regurgitation).
If I do not undergo catheter ablation and instead have valve repair surgery, will the premature beats improve or resolve completely?
Thank you, Doctor.
I apologize for the trouble.
Attached are my two echocardiogram reports.

— Here are my previous two echocardiogram reports:
Clinical Diagnosis:
- M-mode + Section Scan:
- Aortic Root (20-37mm): 25
- LAD (19-40mm): 43
- LVIDd (35-51mm): 47
- LVIDs (28-35mm): 32
- VS (6-10mm): 10
- PW (6-10mm): 10
Comments:
1.
Preserved left ventricular (LV) and right ventricular (RV) systolic function, LVEF = 60%.
2.
Preserved LV diastolic function, E/A = 1.4, Em/Am = 1.5, E/Em = 7.5, Em = 12.4 cm/s.
3.
Dilated: Left Atrium (LA).
4.
Mitral Regurgitation (MR): Mild.
5.
Tricuspid Regurgitation (TR): Minimal.
6.
Pulmonary Regurgitation (PR): Mild.
7.
The Tissue Doppler Imaging (TDI) suggests decreased LV systolic reserve function.
(Lat Sm = 6.4 cm/sec)
Echocardiogram and Doppler Color Flow Mapping:
- LV enlargement
- Preserved global contractility of the left ventricle
- LVEF by M-mode is 60.4%
- Regional wall motion abnormality, cause to be determined
- Grade I diastolic dysfunction (Impaired relaxation)
- Mitral Valve Prolapse (MVP), borderline
- Mild mitral regurgitation
- Mild pulmonary regurgitation
- Mild tricuspid regurgitation
- Estimated systolic pulmonary artery pressure is 21.3 mmHg
M-mode/2D Measurements & Calculations:
- RWT: 0.34
- Time Measurements MM R-R interval: 0.82 sec
M-mode/2D Value References:
- Ao root diameter: 3.1 cm [2.0-3.8 cm]
- LVIDd: 5.8 cm [3.7-5.3 cm]
- ACS: 1.9 cm [1.6-2.6 cm]
- LVIDs: 3.9 cm [2.4-3.6 cm]
- LA dimension: 3.5 cm [1.9-4.0 cm]
- EDV (Teich): 166.6 ml [80-180 ml]
- ESV (Teich): 65.9 ml [16-83 ml]
- MV E-F slope: 17.3 cm/sec [8.0-15.0 cm/sec]
- EF (Teich): 60.4% [50-70%]
- IVSd: 1.0 cm [0.7-1.1 cm]
- FS: 32.8% [FS 34-44%]
- LVPWd: 1.0 cm [0.9-1.1 cm]
- MM HR: 73.0 BPM [60-100 BPM] [EPSS <0.8 cm]
- CO (Teich): 7.3 l/min [2.5-7.2 l/min] [RWT 0.22-0.42]
Doppler Measurements & Calculations:
- Ao V2 max: 84.2 cm/sec
- LV V1 max PG: 2.4 mmHg
- Ao max PG: 2.8 mmHg
- LV V1 max: 77.0 cm/sec
- TR max velocity: 167.0 cm/sec
- sPAP: 21.3 mmHg
- TR max PG: 11.3 mmHg
- MV E max velocity: 82.9 cm/sec [>=50y, 62 ± 14, <50y, 72 ± 14]
- MV A max velocity: 56.8 cm/sec [>=50y, 59 ± 14, <50y, 40 ± 10]
- MV E/A: 1.5 [sPAP < 35 mmHg]
- MV deceleration time: 0.18 sec [DT 0.16-0.22 sec]
- LV IVRT: 0.05 sec [0.07-0.09 sec]
Ventricles:
- Increased dimension of LV
- LVEF by M-mode is 60.4%
- Hypokinesis in the segments of LV including anteroseptal wall
- Mitral inflow: E/A ratio: 1.5
- Isovolemic relaxation time is 0.05 sec
- Deceleration time of mitral inflow 0.18 sec
- Tissue Doppler: E’/A’ < 1
- Septal E’: 10.6 cm/s
- Lateral E’: 11.9 cm/s
- E/E’ (Lateral): 6.9
Atria:
- Normal sizes of atrial chambers
Valves:
- Increased thickness of MV with borderline elongated chordae of MV.

A-Chang, 20~29 year old female. Ask Date: 2022/07/19

Dr. He Dongjin reply Cardiology

Hello, follow-up should be done at most once a year; it should be a measurement error.
A difference of two months is significant.
Undergoing valve surgery will not eliminate premature beats, and no one undergoes surgery for such mild issues.
Valve repair surgery does not involve ablation, and premature beats will not improve.
It's better to coexist peacefully with them for now and follow up later.
Take care, Changhua Hospital is concerned about you.

Reply Date: 2022/07/19

More Info

When it comes to heart health, understanding your echocardiogram (heart ultrasound) reports is crucial. Based on your questions and the details you've provided, let's break down the key points regarding your heart condition and the frequency of echocardiograms.

1. Left Atrial Size and Its Implications
You mentioned that one of your reports indicated a left atrial diameter (LAD) of 43 mm, which is indeed above the normal range (typically 19-40 mm). An enlarged left atrium can be a sign of various conditions, including hypertension, heart valve disease, or atrial fibrillation. While it may not be immediately severe, it does warrant monitoring, especially since you have a history of premature beats (PVCs) and mitral valve prolapse (MVP). The enlargement could be related to the increased pressure or volume load on the heart, often seen in conditions like mitral regurgitation.

2. Frequency of Echocardiograms
Given your history of PVCs and mild mitral valve prolapse, it is advisable to have regular follow-ups. Typically, if there are no significant changes in your condition, an echocardiogram every 1-2 years may suffice. However, if your symptoms worsen or if there are significant changes in your echocardiogram results, your doctor may recommend more frequent monitoring. It's essential to have a personalized plan based on your specific health status and any new symptoms that may arise.

3. Variability in Echocardiogram Results
It is not uncommon for echocardiogram results to show some variability between tests, especially if they are conducted within a short time frame. Factors such as changes in body position, the technician's technique, and even slight variations in measurement can lead to differences in reported sizes. Additionally, if your heart condition is dynamic, meaning it can change over time due to factors like fluid status or physical activity, this could also explain the differences. It’s important to discuss these variations with your cardiologist, who can provide insights based on your overall clinical picture.

4. Mitral Valve Prolapse and Premature Beats
Regarding your concern about whether repairing the mitral valve would resolve your premature beats, it’s important to note that while mitral valve prolapse can contribute to arrhythmias, not all patients experience PVCs as a direct result of this condition. Repairing the valve may improve overall heart function and potentially reduce the frequency of PVCs, but it is not guaranteed. The relationship between valve repair and arrhythmias can be complex, and your cardiologist will consider all aspects of your heart health when discussing treatment options.

Conclusion
In summary, your echocardiogram results indicate some areas of concern, particularly the enlargement of the left atrium. Regular monitoring is essential, and the frequency of echocardiograms should be tailored to your specific situation. Variability in results is common, and any concerns regarding your symptoms or test results should be discussed with your healthcare provider. If you are experiencing significant anxiety about your heart health, it may be beneficial to have a thorough discussion with your cardiologist, who can provide reassurance and a clear management plan tailored to your needs.

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