Ayn's Multiple World

Left Ventricular Hypertrophy

Good morning … this is me. It is already 9:18 am and we’re definitely at work. It’s been a good and a bad period since we’ve left … There have been two things on our mind. The first is that we had gotten a response from Dr. Marvin concerning the Heart stress tests – and we got everything through so that the meatballs are cooking considerately in the food prep room. More of that later though. K? It’s the soft part of the story that we get to to avoid the worrisome thoughts and to work toward the part where we are so close to vacation I can almost taste it. THOUGH there are some things I’m going to need working through. Sister wants the staff sheets signed, and there are four groups from here to now … Hmm, party tomorrow so probably no groups tomorrow – well that’s a relief then. Pshwoo. Ok, so just two groups today to get through and the party tomorrow. I can do this, right?

Hmm, I’m going to need getting some Christmas wrapping paper too. Shoot. Forgot about that. Forgot I need to wrap Sister’s and Margarita’s gift tonight so I can bring it in with me tomorrow morning. I look forward to that brief set of instances.

I will give Sister her gift in private … I hope to catch her in a quiet period later on when her resistances are low and she’ll open the gift right away. Maybe at the staff party … that would be ok, we’ve done that before. I’ll have to check today to see if there is some paper around here otherwise we might have to pick some up somewhere, maybe at Walgreen’s that might be quick enough for me to stand. We’ll see.

Ok, we’ve prepared our office a bit – in case Sr. comes back – pswhoo … that took some pressure off. We had given her enough time to get group I and Leadership off.

They were going to Millennium Park today. That won’t interfere with any groups, but it did cancel out an individual appointment with the one who comes in to do a music goal. But, anyway I walked up front and saw that the bookkeeper was in and Sr. was counting through checks. Obviously, she was busy … I said that it wasn’t anything important and I’d just give her these things to read later … one was to clarify the food diets that we had talked about for Holly and myself. And, the second was about the results of the Test on Tuesday, and then the description of that result. I also told her I was expecting a call from the heart center and that I was to be interrupted from any group to catch the call. She seemed to pick all of that up.

So, I left … I had done my good Ann. I had notified everyone that I should have notified. I’ve done good. Dr. M., Rich, Maury, Sr. Joe would be the next one, but he’s not on the top of the list until something more concrete was found … and then sometimes things like that are explained by Maury – but, might better wait until an event like meeting for dinner on Saturday. No reason to alarm. It was here yesterday, is here today, and will be here tomorrow … nothing is really new, but our awareness. Maybe something will be done … Hmm, you don’t know what I am talking about do you. Ok, I’m sorry. Forgot. The quickest way to explain – and, I’m sorry the longest way is to give you a clip of Dr. M’s note, then add the explanation of left ventricular hypertrophy from Mayo Clinic. I’ll meet you at the bottom.

Start here.

Hi Ann,

I'm glad the test went OK. I looked in the record. There is a preliminary report from the test. The conclusion is listed as:

V. CONCLUSION:

1. Very technically limited study.

2. Left ventricular hypertrophy with normal systolic function.

3. Grossly normal dobutamine stress test although imaging very limited.

I am not an expert at reading the results, but it looks like it was an OK result. No significant problems.

-Dr. M



HEART DISEASE

Left ventricular hypertrophy

Introduction

Left ventricular hypertrophy refers to a thickening of your heart muscle's main pumping chamber (left ventricle). Although left ventricular hypertrophy itself isn't a disease, it is a marker of an underlying health problem.

The thickened muscle usually develops in response to chronic high blood pressure or excessive blood volume filling the left ventricle, which creates more work for your heart. Over time, the overdeveloped heart muscle may wear out and eventually fail.

The incidence of left ventricular hypertrophy (LVH) increases with age and is more common in people who have high blood pressure or have other heart problems. Whatever the cause, left ventricular hypertrophy places you at an increased risk of major heart and blood vessel complications, compared with people without the condition.

You can reduce your risk of developing left ventricular hypertrophy by controlling high blood pressure or by getting treatment for other conditions that can lead to left ventricular hypertrophy.

Signs and symptoms

Signs and symptoms of left ventricular hypertrophy depend on the underlying cause.

Left ventricular hypertrophy usually develops slowly, so there may be no signs or symptoms for many years or none at all. If signs or symptoms are present, they may include:

Shortness of breath
Chest pain
Irregular heartbeats
Dizziness
Fainting
Causes



Left ventricular hypertrophy

Your heart muscle responds to an increased workload much like your arm muscles respond to weightlifting — by enlarging and thickening. As the muscle cells of your heart increase in size, the heart wall widens. However, unlike your biceps muscle, which rests when you put down the dumbbell, your heart muscle must work nonstop.

Left ventricular hypertrophy may take up anywhere from weeks to years to develop. Over time, the heart muscle becomes "stiff" and the amount of blood that the heart can effectively pump out to the body begins to drop. Left untreated, the overdeveloped heart muscle will wear out and eventually fail.

Left ventricular hypertrophy usually develops in response to excessive blood pressure (pressure overload) or excessive blood volume filling the left ventricle (volume overload).

Pressure overload
Causes of pressure overload include:

Hypertension. Blood pressure is determined by the amount of blood pumped by the heart and how the blood vessels respond to the pressure (resistance). High blood pressure is the most common cause of left ventricular hypertrophy.

Aortic stenosis. This is a condition in which there's a narrowing of the aortic
valve, the flap separating your heart from the aorta, the large blood vessel that branches off your heart and delivers oxygen-rich blood to your body. When the aortic valve is narrowed, blood flow from the heart into the aorta and on to your body is obstructed. Aortic stenosis causes blood pressure to build in the left ventricle.

Volume overload

Causes of volume overload include:

Aortic valve regurgitation. Aortic valve regurgitation is a condition in which the heart valve separating the left ventricle and the aorta doesn't close properly, resulting in some blood flowing backward into the left ventricle. This increases the volume of blood in the left ventricle.

Dilated cardiomyopathy. Cardiomyopathy refers to a weakening of the heart muscle.

The condition may be inherited or acquired later in life. Dilated cardiomyopathy involves the enlargement of one or more chambers of your heart. An enlarged left ventricle is able to fill with more blood and requires more force to pump it out to your body.

Left ventricular hypertrophy can occur in the absence of pressure or volume overload. An inherited condition that causes a thickening in part or all of the heart (hypertrophic cardiomyopathy) can cause left ventricular hypertrophy.

Risk factors

High blood pressure is the key risk factor for left ventricular hypertrophy because your heart must work against increased pressure. Other risk factors include:

Age. Age is an important risk factor because conditions that increase the risk of left ventricular hypertrophy, such as high blood pressure, tend to develop as you get older.

Obesity. Obesity refers to an excess storage of body fat. If you're overweight, your heart has to work harder to deliver blood to your organs.

Pre-existing coronary disease. Coronary disease refers to blocked blood vessels that supply blood to your heart muscle. If your heart muscle isn't receiving enough blood due to clogged vessels, your heart responds by pumping more forcefully.

When to seek medical advice

If you have signs or symptoms such as severe chest pain, fainting or sudden onset of shortness of breath, contact your doctor or call 911 or emergency medical help.

While experiencing these signs or symptoms doesn't necessarily mean that you have a serious problem, it's best to get checked quickly. Early detection and treatment of a serious heart problem may help save your life.

Screening and diagnosis

Signs and symptoms of a health problem that may lead to a diagnosis of left ventricular hypertrophy are often discovered during a physical exam. Your doctor may detect elevated blood pressure or hear abnormal heart sounds in your chest. To make a definitive diagnosis, your doctor uses one of the following two tests:

Echocardiogram. The echocardiogram is the preferred technique for diagnosing left ventricular hypertrophy. This test uses high-pitched sound waves to produce an image of your heart. Sound waves bounce off your heart and produce moving images that can be viewed on a video screen. Echocardiograms determine the thickness of the heart wall and can help detect other heart abnormalities that may have caused left ventricular hypertrophy, such as aortic stenosis.

Electrocardiogram. An electrocardiogram records the electrical activity in your heart each time it contracts. During this procedure, patches with wires (electrodes) are placed on your chest, wrists and ankles. The electrodes measure electrical activity, which is recorded on paper. If left ventricular hypertrophy is present, the electrocardiogram detects abnormal electrical activity.

Complications

The risk of complications depends on the severity of the left ventricular hypertrophy — the thicker the muscles in the left ventricle, the greater your risk of complications. The most common complications include:

Arrhythmia. An arrhythmia is an abnormal heart rhythm — that may be felt as a fluttering in the chest — resulting from a disruption in the electrical activity of your heart. Arrhythmias range from mild to life-threatening.

Congestive heart failure. If you develop left ventricular hypertrophy, your heart may lose its ability to deliver enough blood to meet your body's demands. As your heart fails, fluid may also back up (congest) in your lungs.

Ischemic heart disease. A thickened heart muscle compresses the small vessels feeding your heart, resulting in an insufficient amount of blood to your heart.

Without adequate blood flow to the heart muscle, your heart becomes starved for oxygen (ischemic).

Unexpected sudden death. People with left ventricular hypertrophy are more likely to have an irregular heartbeat than are people without left ventricular hypertrophy.

Severe irregular heartbeats are associated with an increased risk of sudden death.

Treatment

Treatment for left ventricular hypertrophy focuses on the underlying cause of the condition. Depending on the cause, treatment may involve medication or surgery:

Treating high blood pressure. High blood pressure is the most common cause of left ventricular hypertrophy. Doctors often prescribe medications to lower blood pressure, such as "water pills" (diuretics). Severe high blood pressure requiring intensive care may be treated with drugs given through a vein (intravenous) called diazoxide and sodium nitroprusside. Your doctor may also recommend that you follow a low-salt diet.

Aortic valve replacement. Leaky aortic valves allow blood to flow backward into your heart. Replacing a defective valve helps keep blood flowing normally into the aorta.

Surgery for hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is an inherited condition that causes a thickening in all or part of your heart. If the hypertrophic cardiomyopathy is severe, your doctor may recommend removal of a portion of the thickened muscle wall that interferes with blood flow.

Prevention

The best way to help prevent left ventricular hypertrophy is to keep your blood pressure within the limits recommended by your doctor. Here are a few tips to better manage your blood pressure:

Monitor high blood pressure. If you have high blood pressure, get a home blood pressure measuring device and check your blood pressure frequently. Schedule regular checkups with your doctor.

Make time for exercise. Regular exercise helps to lower blood pressure. Aim to engage in 30 minutes of moderate activity at least five times a week. Talk to your doctor about whether you need to restrict certain physical activities, such as weightlifting, which may temporarily raise your blood pressure.

Watch your diet. Eat foods high in fat and salt sparingly and increase your consumption of vegetables, fruits and low-fat dairy products. Drink alcohol and caffeinated beverages in moderation.

In addition to controlling high blood pressure, it's important to monitor other health conditions that increase your risk of heart disease, including diabetes and high blood cholesterol.

Finish Here


Ok, you got me again. I haven’t read the report again today, but I read it about 3 times yesterday. I’m trying to decide if I should be concerned without knowing from the Dr. what it is that I should or should not be concerned about. There is really two things. Do I have to do anything for this condition, does it need an operation – well, three, and is it going to interfere with gastric bypass surgery. Those are the things that I want answered directly. I left a couple messages at the heart center, but I don’t like the way that staff operates. I got the idea that they are like trying to push responsibilities off on each other. It’s one of those things where I think as a patient you have to be paying attention. AND, it might not hurt to have Dr. Marvin place a call to get a reading on the situation to explain it better to me. Maybe I’ll give it until after the 1 pm meeting. If I haven’t heard back by then from the heart people I will ask Dr. Marvin to place a call over to them … then we can talk about it at the 4 pm meeting. Cuz, I’m going pretty you know what again. I go through stages with it.

Hmm, we just wrote to Dr. Marvin. We said:

Dear Dr. Marvin,

I am getting very anxious not hearing back from anyone about the left ventricular hypertrophy (LVH). I tried getting hold of someone last night at the U, but it got messed up each time. I left a message directly with the heart people before I left for work, last night, and early this morning and no one has called. They had said ... the doctors AND the nurses that they were going to call me yesterday with the results and NOONE called.

The things I want to know now is do I have to do anything for this condition? Since I don't have the problem with high blood pressure - do I have the kind with volume overload that could require surgery? What level of a problem do I have? It seems that having normal systolic function is good, is there a specified range? Am I ok? And, does this affect my weight loss surgery? It seems more likely than even before I have a reason to be losing the weight. Oh, one more - it says that it is a marker for an underlying health problem - is there anything else that we should be looking for?

It is already 10 am. I will be in meetings from 12-2. I've given instructions to be called out of meetings if I get a phone call, but if I have not gotten a phone call by 2 pm, could I email you and ask you to call the doctor and have the questions answered - unless you already know the answers. I would very definitely like to talk about it with you at today's meeting before the long break. I don't want this to fret over. I want more than the "pat" answer ... I'm more complicated than that. :(

Ann

Ok … I’ve been gone about 20 minutes doing Christmasy stuff. We looked up front for sister to to check the list. I need to find if anyone is making mashed potatoes, because there will be lots of gravy from the meatballs and it needs to go somewhere. If no one is doing it I will check with Sister, but will probably make it. That’s something though that sister might make, so I’ll be sure to double check. The meatballs are coming along nicely. There is a lot of the sauce so the meatballs are floating in it. I hope that is ok. I might have to ask Maury for his potato recipe though. It was WONDERFUL! And, it was heavy enough to go with the dinner … he made a huge serving.

Ok, I IM’d Maury … Hopefully, he’ll let me know before I talk to Sister, because if she says she’s making a simple box recipe and Maury’s recipe is like real potatoes … and I can do it … maybe I’ll ask her to go with his … If his recipe is a box … I’ll turn over in my future grave! His had a swirl of cheese too. It was sooo good. I’m at a point now where I am almost hoping that I could make it. I think everyone eats mashed potatoes during the holidays – especially if they been smelling the gravy for two days … Hmm, I hope they don’t get sick of it.

OK< OK…. NOW … someone has to do the meetings?

Ok, figured all that out. Ready for the CIRCLES for GROUP II and the Staff Meeting. We’re going to go over the Package given out during the annual. Usually this happens after they leave. And, it’s good to do it today while Candice isn’t here, so she doesn’t get bored. Hmm, Maury gave me directions on how to do the potatoes, but then recommended for our group to do the boxed potatoes. He’s right … we just gotta find out from sister now.

We went and checked the meatballs. They were doing their thing. The room is starting to smell pretty good. Nobody knows really that I did the meatballs, though if staff uses the dining room, pretty sure someone is going to look over there to see what’s cooking – and they will figure it out … maybe some will remember it was what I’d written down, but one way or another it will be confirmed at staff training. I’ve gone in faithfully once an hour to stir them. I love that they are still floating … I hope that isn’t a problem and there is enough juices to turn them into the meat sauce, but we’re not going to over worry, because they smell right and that’s the good part. I hope Sr. gets to smellin them too. They will be in the fridge by the time she closes up tonight – checks the door, but maybe she’ll poke her head in for the meeting. I want my boss to know HEY ANN CAN COOK!! Hehehe I don’t think it will give me a raise or bonus, but it’s a nice surprise! Bonus with loosing weight – I feel more able. Maybe next year – potato salad Mmm! AND a dessert!

You know the biggest deal with the meatballs this year? It’s the whole visual thing. I made the 3 pounds which is good – We could have gone 4 pounds, but the thing is that Rich remembered for us that we have a bigger slow cooker. We forgot … we’re used to using the ceramic crock pock we got for a wedding gift for the meatballs, which is tall and less manageable. But, this other is that material that is easy to clean and it’s wide and open. So the same amount of meatballs look artistically placed – even when I made the 10 cup recipe of sauce. Wow … just so cool. I think whatever Rich says for potatoes though we are going to want to double it, because the meatballs will go and I want the sauce to come home WITH potatoes!

Hmm, speaking of potatoes. It’s time for lunch better start on that. Woo, we are being covered on all ends here. Maury had talked in an IM about the potatoes asking how many people and Theresa had come in with the list and we’d gone over it. Definitely no mashed potatoes – though Brandi is bringing potato salad. I think she’s planning on buying it. I saw now too that Sr. is planning on doing the drinks. That’s a good idea. I knew she does some back-up kinds of stuff. WooHOO I’m getting excited – though we’re still not sure what to do with eating stuff – maybe we can take something home for tomorrow night. Just we’ve been doing so good. I was proud to say that to Maury.

We just sent a set of ingredients to Rich of stuff that we are going to need for making the potatoes. Who knew this could be so exciting. Oh man – see that was the other part that was so exciting that we haven’t gotten to last night. Rich picked up the missing parts we needed for meatballs last night. There were only 4 things that we needed to get. He took things out of the bag and we made his drink. Then we worried over missing another phone call from the stranger doctor. In the meantime – Rich and I started naturally making the meatball dinner together. He added the ingredients to the big bowl and chopped up crackers and cut the onions, I mashed them all up – hamburger and all with my hands. I rolled the balls and he browned them. It took about an hour and 20 minutes. So that wasn’t bad. My poor baby was tired though. We had to decide early on he couldn’t read too much while there were meatballs to watch. Oh dear, not in our kitchen! He’s used to turkey cooking! Hehehe He also carried the pan down the stairs and put it in the car for us, which was super nice.

Ok, let’s get off the subject? Awe … c’mon it’s Christmas! 11:54 am too … pretty soon gotta do the groups. Ok, now … anything left? I guess I should go to the bathroom and check if sister’s around on the potatoes ok heading out!

Pswhoo… we’re back again. It’snow 2:45 pm. I figure about an hour and we’re out the door to Dr. Marvin’s … We’ve been busy this last 3 hours. We went to a meeting with ohhhh you know all that. Let me tell you it was a tough one though, because doesn’t matter if you are a client or a staff the only thing you got on your mind about now is CHRISTMAS!!! It’s almost here. I felt good because the meatballs had a positive effect on everyone today. Even the clients! I’d forgotten about them. Hehehe … their poor noses had to walk past the door too though. Someone said something about the good smell and I said – oh yeah, do you all smell that good smell. And they got excited and then it was like yah and then I told them we had done it and I don’t think even they could believe it goofy guys. It came up with the staff at the beginning, middle and end of the meeting.

But, more than anyone – well and there’s Sister, but I was particulary happy with Margarita … I could tell they were breaking her concentration. She mentioned them several times. The last time she said I would like to get about 40 tortillas and we could sit down right now and eat them all! Hehehe oh man that about just broke my heart. I’ve been worrying so much over how did Margarita think of me. I think in her eyes I did something right. When Sister came in there was a few things, but I think she’s proud of me too. We’re too close now so we’ll have to hold off

Wow that was something … we just had a very intimate moment with Margarita and Sr. Theresa. I had gone in to take the pan off the plate and Sr. and Margarita were messin around with table clothes for tomorrows party. I think they were doing something else, but I forgot, but early on Sister came over and declared that she was going to try a meatball … she was soooo funny in one of those heart-tender moments. Man it was something. Have to come back here later to get it right. The bottom line was that she liked the meatball. She said that it hit the spot because she was only going to have soup for dinner tonight. I have to assume that the Sister MM is out tonight. Sister Theresa said she would come back after chapel to put it in the fridge for me. She said to put it on the hot plate on low tomorrow at 9:30 so that sounded good to me.

There was another cool thing too … she asked about what was in the sauce and she asked if I made it by hand and if I’d made the meatballs by hand, Yup yup!!! I told her what was in the sauce and then later I told her how much of each. I can’t believe it an old Italian nun taking down OUR recipe wooHOO!!! Made me feel like a million bucks! We teased her on the way out about counting the meatballs and Margarita repeated it so she could hear. Sr. said something funny and I can remember saying – yeah you and your buddy Margarita. It was just a wonderful time. All the time mostly though I kept quiet on the side chair and just watched the two work … they are truly a great, great team. They move around each other well. Hmm. I wonder if Dr. Marvin would like a meatball? Could I get him one? No, it wouldn’t be possible I think with the wheel chair. Nothing to carry it in. I don’t have plastic containers with lids I think. Shoot no time to think here. But, I gotta go. Better scram!

posted by Ann Marie @ 12/22/2007 03:10:00 AM Comments: 0