Exercise ECG and Echocardiogram Results: Key Insights - Cardiology

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Based on the exercise ECG and echocardiogram results you've provided, let's break down the findings and their implications for your heart health.


Exercise ECG Interpretation
1. Heart Rate and Blood Pressure: Your maximal heart rate achieved during the exercise test was 148 BPM, which is approximately 89% of your target heart rate (THR) of 165 BPM. This indicates that you were able to exert yourself significantly during the test. The peak systolic blood pressure reached 180/91 mmHg, which is a normal response to exercise, although the systolic pressure is on the higher side.

2. ECG Findings: The exercise ECG showed sinus tachycardia and non-specific ST-T changes. While sinus tachycardia is a common response to exercise, the presence of ST-T changes can indicate potential myocardial ischemia, especially if they are downsloping or flat. However, your overall conclusion from the test was "negative, probably," suggesting that while there were some changes, they may not be significant enough to indicate severe underlying heart disease.

3. Termination of the Test: The test was terminated due to shortness of breath (SOB) and leg soreness, which are common symptoms during exercise testing but should be monitored closely.


Echocardiogram Findings
1. Left Ventricular Function: Your left ventricular ejection fraction (LVEF) is reported at 72.5%, which is within the normal range (typically above 55% is considered normal). This indicates that your heart is pumping effectively.

2. Diastolic Dysfunction: The report mentions Grade II diastolic dysfunction, which suggests that while your heart can contract well, it may have some difficulty relaxing. This can lead to symptoms like shortness of breath, especially during exertion.

3. Valvular Issues: There are minimal regurgitations noted in the aortic and mitral valves, as well as mild tricuspid regurgitation. These findings are generally not severe but should be monitored over time.

4. Pulmonary Artery Pressure: The estimated systolic pulmonary artery pressure is 31.9 mmHg, which is slightly elevated but not alarming. Normal values are typically below 25 mmHg at rest.


Regarding Your Symptoms
You mentioned experiencing ankle swelling after sitting for prolonged periods. This could be related to several factors:
- Circulatory Issues: Prolonged sitting can lead to venous stasis, where blood pools in the lower extremities, causing swelling. This is often not directly related to heart function but rather to circulation and fluid dynamics.


- Heart Function: While your echocardiogram shows preserved left ventricular function, diastolic dysfunction can sometimes contribute to fluid retention, especially if the heart struggles to manage fluid balance effectively.


Recommendations
1. Regular Monitoring: Given the findings of diastolic dysfunction and the ST-T changes during exercise, it would be prudent to have regular follow-ups with your cardiologist. They may recommend further testing, such as a stress echocardiogram or even coronary angiography, depending on your symptoms and risk factors.

2. Exercise: You should engage in regular, moderate exercise. Avoid overly strenuous activities until you have further clarification from your healthcare provider regarding the ST-T changes observed during the exercise test.

3. Lifestyle Modifications: Consider lifestyle changes that can improve circulation, such as elevating your legs when sitting, taking breaks to walk around, and staying hydrated.

4. Consultation: If you continue to experience symptoms like shortness of breath or significant swelling, consult your healthcare provider for a more in-depth evaluation.

In conclusion, while your heart function appears to be largely normal, the presence of diastolic dysfunction and exercise-induced ECG changes warrants careful monitoring and possibly further investigation. Regular follow-ups with your cardiologist will help ensure that any potential issues are addressed promptly.