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Heart & Cardiology/Mild Diastolic Dysfunction

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QUESTION: Dear Dr. Richardson:

I had asked you questions before for my mother. She is 65 years old (overweight) and her recent echocardiogram shows that she has:

1) Very mild aortic stneosis, mean gradient is only 9 mm Hg and the valve area is 1.8 cm square. Doctor said it is 'trivial'.

2) Mild left ventricular hypertrophy , LVPW is 1.2 cm (normal range is 0.6-1.1 cm) and IVS is 1.2 cm (normal range is 0.6-1.1 cm)

3) Mild diastolic dysfunction  (left ventricular relaxation abnormality)

She has no heart related symptoms (No shortness of breath and no chest pain).

Is mild diastolic dysfunction something that we need to worry? I google the internet that a few studies have shown that mild diastolic dysfunction is far more common that peope thought. Quite many healthy people have it without knowing it and live a whole long life. Is that true?

As for the very mild (borderline) left ventricular hypertrophy, is that reversible or do we need to worry?

The cardiologist did not seem to worry too much about the very mild aortic stenosis. In fact, the mean gradient seems to be better than the cardioechogram done back in 2011.

Are there any big cause for concern as far as these 3 conditions?

Thank you very much.

Felix

ANSWER: Hello Felix,

No, you can be happy.  With no symptoms, she has no threats from mild diastolic dysfunction, minimal aortic stenosis, or slight left ventricular hypertrophy.  I don't know if the LVH is eversible, but it won't harm her.

Please write back if this note doesn’t answer all your questions.

David Richardson

---------- FOLLOW-UP ----------

QUESTION: Dr. Richardson:

Thanks. I forgot to mention her ejection fraction (EF) is 70% from that same cardio-echogram. I believe it is good, right?

Are the possibilties of worsening of mild diastolic dysfunction and minimal aortic stenosis very low in the future? I am a big worrier espeically when it comes to my mom's health.

Do most of the people with mild diatolic dysfunction never develop serious problem from it? As I found that it is pretty common.

Thank you much again for your kindness.

Felix

Answer
Yes, EF over 50 and under 80 is very good.

Worsening of aortic stenosis and diastolic dysfunction are possible,but worsening of either to a degree that would make her fee bad is very small.  Most people with either mild diastolic dysfunction or minimal aortic stenosis never develop serious problems.

Heart & Cardiology

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David Richardson

Expertise

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

Experience

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.

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

Publications
Circulation, American Heart Journal, Hypertension.

Education/Credentials
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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