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QUESTION: Hi doctor
I had a heart cath done back in 05/2014 and in that time they told me at the hospital tgat everything looks normal I did it because I had chest discomfort like heaviness and it was most in the right side they did a heart cath through my right arm, and said the chest pain is likely non cardiac today when I went to pick up a copy from my medical record I found a note saying moderately elevated left ventricular diastolic filling pressure and they mentioned nothig about it to me can I know what dies this mean , also it says left ventricular contracility is normal, the lv cavity is normal, LVEDP 23 mmHg, and LV ejection fraction : EF 55%, am a 30 years old female

ANSWER: Hi Dina, http://myheart.net/articles/diastolic-heart-failure/ http://myheart.net/articles/diastolic-heart-failure/


The good news is your arteries were relatively normal with no significant blockages. The contractility was normal meaning the pumping function of the heart appeared normal when they used dye to assess that. 55% is the normal value. All good things.

The lvedp stands for left ventricular end diastolic pressure. This basically tells you whether there is increased pressures in the heart that can amount from a number of things such as relaxation abnormality of the heart or other types of heart failure. In your case the pumping function is normal so the value likely represents something we call diastolic dysfunction, i.e the heart relaxes abnormally, possibly due to high blood pressure. This can be responsible for symptoms such as shortness of breath. The treatment is based around control of blood pressure, sometimes use of diuretics to take out excess fluid. Ive linked a few articles above that explain this in detail. I wouldn't worry too much, if treated and you are doing clinically well, this is not as severe as other forms of heart failure.

i would call the dr ho did the procedure or ordered it and ask to discuss the elevated filling pressure, and the treatment they plan to do. If you have no symptoms, this will likely be based around treatment of risk factors for heart disease such as diet, exercise, blood pressure etc.

Hope that was helpful,



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

QUESTION: Thank you doctor for your reply but I have a question her what are the normal levels for LVEDP? And how bad is mine? And how can I lower it to yhe normal level ? Also I never had high blood pressure mine always aroun 100/60 also do I need to be concerned about as the doctor who did it was at the emergency room and there is no way I can reach him .

ANSWER: Hi,

I would say >16 is abnormal, but its important to mention that a lot of the reading depend on the condition under which it was performed and also whether the tracing was reviewed for accuracy, i see a lot of abnormal readings where people have simply not reviewed the tracing and have just gone with the machine value. If you had symptoms such as shortness of breath then i would say the elevated value may mean that heart failure could be contributing to this. Your function is normal as per your echo, and your LVEDP mildly elevated, but like i said that may depend on the tracing. Ask the physician performing the test to review and discuss.

Hope that was helpful,

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

QUESTION: So if I dont have shortness of breath its not a problem ? And also how can I lower it to the normal level? Please excuse me if am asking too much questions but am a mother of 2 little kids 8 & 6 years old and am really worried about my health , thank you so kuch again for your caring and taking the time to reply back to me

Answer
Hi, No worries about the questions, I'm happy to help.

My approach to your situation would be the following. I'll emphasize that before even beginning to worry about anything i would review the tracing, its perfectly possible the tracing is not abnormal at all. Secondly there are a number of factors that can alter the LVEDP such as heart rate, blood pressure at the time, etc. i would interpret the value in relation to the situation. Im pretty sure that if there was anything to worry about your cardiologist would have informed you by now.

An elevated LVEDP doesn't mean heart failure, and a normal LVEDP doesn't rule it out. What the LVEDP can do is help to guide treatment of symptoms and heart failure. In the absence of symptoms then its not entirely sure what the significance of an elevated LVEDP is. If your heart cath was otherwise normal the only other test i would consider is an echocardiogram. If that is normal also then i would be reassured and wouldn't really be worried. If you had symptoms such as shortness of breath, but otherwise normal heart function then the mainstay of your treatment would be ensuring good control of risk factors for heart disease such as blood pressure, and also advising regular exercise.

Hope that was helpful.  

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Mustafa Ahmed MD

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Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

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Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

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Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

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MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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