Heart & Cardiology/echocardiogram results


It's great to be able to ask you questions as I have to wait many weeks to see a cardiologist. I am a 52 year old female, 150 lbs, 5'5''. I am a smoker. I take ecitalopram for depression, mirtazapine & clonazepam for sleep and concerta for adult ADD. About 2 weeks ago, I had a syncopal episode with chest pain, dizziness, profuse sweating and difficulty breathing. I had been experiencing very severe fatigue for about a month prior to that and had put it down to depression or stress-related fatigue. I called the ambulance and the paramedics did an EKG- my t-waves were inverted (not sure which leads), my BP was 60/90 and my heart rate was in the low 30s. I was in ICU for 5 days with bradycardia, chest pain & pressure, neck pain, fatigue and headache. I was also mildly hypokalemic.

I got the results of my echocardiogram today. It showed a mildly dilated ascending aorta (40mm), elevated LVEDP 41mm (B notch on M mode), trivial mitral regurgitation and mildly thickened aortic valve trileaflet. There were also 'tiny color pixels noted in the region of ductus arteriosus with no definite evidence of communication to the pulmonary artery'.

Currently, I am experiencing severe fatigue, heart rate in high 40s/low 50s, slightly low BP and chest heaviness with occasional pain.

Any ideas appreciated- it is a bit scary!

Hello Joy,

Your symptoms suggest congestive heart failure, which causes fatigue and breathlessness but usually is accompanied by swelling of legs and trouble breathing especially when lying flat, so I'm not sure.   The elevated LVEDP also suggests congestive failure. All that chest pain and invertedT waves suggest narrowing of the coronary arteries that supply blood to the heart.  Ask for the left ventricular ejection fraction on your echo.  If over 30%, I would recommend coronary angiograms to see if any narrow places should be dilated or bypassed.

Please write back if this note doesn’t answer all your questions, and PLEASE let me know what you find out.

David Richardson

Heart & Cardiology

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David Richardson


Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.


Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Circulation, American Heart Journal, Hypertension.

M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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