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Holter And Echo Results


~Naomi~
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Holter showed mostly what I expected. I was tachycardic 5 out of 24 hours. Looks like on and off all day, probably with standing and moving. Not a big surprise, but weird to hear the total amount of hours, you know? I was surprised I was also tachy at 1am while asleep- didn't know that was happening. Highest heartrate was 152 (shortly after getting out of bed) and lowest was 58 at 4:30am while asleep. His report says that I had an abnormal EKG. This is news to me because he said it was normal. The echo he told me was normal, but it says on the report under Diastolic Function "Analysis of mitral valve inflow, pulmonary vein Doppler and tissue Doppler suggests grade 1 diastolic dysfunction without elevated left atrial pressure." So he agreed that I had this "Tachycardia Syndrome" (I wasn't looking for confirmation, but OK) and is referring me to a local electrophysiologist (I've never heard of) who supposedly has POTS knowledge. I'm thinking if there was anybody local with knowledge, I would have found him by now. I'll check him out just in case, but not too optimistic.

Does anyone know what this means? "Analysis of mitral valve inflow, pulmonary vein Doppler and tissue Doppler suggests grade 1 diastolic dysfunction without elevated left atrial pressure."

Thanks. :)

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I have diastolic dysfunction too. It has to do with the resting part of your heart. Of course, it is reflected in the bottom number of your blood pressure reading. Some of us with this also have mitral valve issues. Have you noticed if you have problems lying on your left side?

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Hi Naomi, As Issie said, diastole is when your heart relaxes and fills with blood. So the heart fills with incoming blood returning from the brain by the superior vena cava and from the body by the inferior vena cava. The heart fills following a cascade: pulmonary veins, left atrium, mitral valve and finally left ventricle. When the latter cannot be filled properly with blood, this cascade fails and starts a backflow process, regurgitating first into the left atrium. The fact your left atrium is unaffected is real good news. They also mentioned grade one diastolic dysfunction, which means it is mild. So, I wouldn't worry. Just wondering why the doctor didn't take the time to explain the results. It is unnerving they don't seen to think it is necessary to break things down for us. I often had to consult my GP to get answers specialists wouldn't give me. Hope this helps!

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There also seems to be a connection with many of us with EDS. More of us are having this problem. I found an article that describes the issues involved with collagen and diastolic dysfunction. It also shows there is a relationship with renin-angiotensin II - aldosterone. There is also a connection with NO - needing more of it.

http://circ.ahajourn...05/12/1503.full

Issie

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Thanks for the explanations. I read the article, Issie, but it was hard for me to understand. One of the things I noticed though- it said this can be treated with diuretics and they recommend reducing salt, which is the complete opposite recommended for POTS. My BP dropped pretty low after IV saline, so maybe I do need the opposite treatment? :huh: I also read this is often found in CFS patients and I'm actually looking into EDS next month with a geneticist. All I know is my last echo a few years ago didn't show diastolic dysfunction. (Actually it showed mild mitral regurgitation, which this one did not show? Another :huh: ) But this does make me wonder if all this tachycardia could be doing some damage over time.

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I have wondered that myself Naomi. When I started having severe edema and what appeared to be CHF issues ---that got me to looking into things more. They found the diastolic dysfunction first and then they found I have Chronic Kidney Disease. Both of these things can cause edema problems. Now, whether some POTS med that I've tried contributed to this ---is yet to be determined. But, hoping that I can reverse some of the damage to both organs with what I'm attempting to do with my diet. I guess time will tell more for us all.

And yes the treatment for diastolic dysfunction is diuretics and is also used for chronic kidney disease. I'm to see my kidney doctor in a few weeks and get the results of some more test that he has done. My nuclear renal scan showed mild dysfunction with the working part of my kidneys. One kidney is not functioning as well as the other. I don't know if he will put me on meds or just keep a close monitor on things. We will see.

Issie

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