Looking for information and possible causes of asymptomatic cardiac enlargement
July 1, 2007 10:09 AM   Subscribe

Looking for information and possible causes of asymptomatic cardiac enlargement : details inside.

Hi , I am acting as a relay for an italian friend that doesn't speak english and is looking for information around the world.

Local specialists are befuddled and so far diagnosed "asymptomatic cardiac enlargement". Global left ventricle enlargement, significant reduction of the cinesis (ipocynesis) of the left ventricle, important reduction of the systolic indexes, reduced diastolic functionality

The patient is a 60 years old female with an extremely stressing lifestyle, easily pulling 12 hours a day of intellectual work for the last 30+ years.

In 2003 she started suffering some very occiasional episodes of tachycardy. She was subjected to an ecodoppler test that proved to be inconclusive. Doctors expected leg swelling and breathlessness, but the patient didn't show any of such symptoms.

The patient was prescribed beta-blocking drugs and cardioaspirin and so far show a significant reduction of tachicardy (from 100 beats down to a max of 80 and a lower average) and a reduction of asystolic events, which almost disappeared.

She is looking for information about causes, genetic or viral still not being excluded, cures and procedures that could be useful in finally understanding what is causing her heart problems.

Thanks for your time :)
posted by elpapacito to Health & Fitness (6 answers total)
Hard to say based on your description, especially the "asymptomatic" part, but the term you may be looking for is "dilated cardiomyopathy."
posted by gramcracker at 10:26 AM on July 1, 2007

Response by poster: Thanks Gramcracker, i checked "dilated cardiomyopathy" on google and among the results :
o Fatigue

o Dyspnea on exertion, shortness of breath

o Orthopnea, paroxysmal nocturnal dyspnea

o Edema
Are some of the symptoms associated with it. But these symptomps are NOT shown by the patient, that's why the local doctors refer to it as "asymptomatic"
posted by elpapacito at 10:44 AM on July 1, 2007

Here are the results I got from googling "enlargement of the heart" + "no symptoms."
posted by amyms at 11:02 AM on July 1, 2007

Cardiomegaly might be a helpful search term. That site, from the Mayo Clinic, is pretty brief but does suggest a few possible causes, and notes that some patients show no symptoms.
posted by Siobhan at 12:07 PM on July 1, 2007

Best answer: People's can have evidence of cardiac dysfunction before it becomes uncompensated or in other words symptomatic.

Based on the data you included, her condition isn't "asymptomatic cardiac enlargement," as this is, say, what Lance Armstrong or other elite athletes might be described as having. She doesn't just have enlargement. She has both systolic and diastolic dysfunction, which means that her heart is having trouble with both squeezing as well as it should, as well as relaxing to accept the flow of incoming blood. Furthermore, without having the actual dimensions, it's impossible to know whether this would be considered "dilated," "hypertrophic," or niether, but it could be classified as cardiomyopathy. And though she is asymptomatic now, if she does have significant hypokinesis, she is at high risk for developing congestive heart failure.

The list of things that can cause this is actually extremely long, but generally the two categories worth differentiating are ischemic (meaning caused by impaired blood and oxygen flow into the coronary arteries that supply the heart), and non-ischemic. Among the list of things that can cause cardiomyopathy, chronic tachycardia is also included. That said, in a 60 year-old, the more likely cause is ischemic, so typically if it is unclear, many patient's in the United States at least, would undergo cardiac stress testing of one form or another, and angiography to evaluate the coronary arteries.

Hope that helps. It's a little difficult to go too in depth into the subject without getting long-winded, so if you have any particular questions from the standpoint of gaining additional info feel free to ask. Of course, we aren't her doctors so...
posted by drpynchon at 12:25 PM on July 1, 2007 [1 favorite]

Response by poster: drpynchon thanks for your very detailed answer I am relaying info to the patient.
posted by elpapacito at 4:00 PM on July 1, 2007

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