Thalassemia Patients and Friends
Discussion Forums => Thalassemia-related Issues => Topic started by: nice friend on January 05, 2016, 11:12:59 PM
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hi ya all ,,
please help me understand an EchoCardioGraphy Report ....
Detailed Report:
Levocardia with situs Solitus
Normal Pulmonary and Systemic venous connections
Intact IAS
Intact IVS
Mildly Dilated IVC
Good Biventricular Systolic Function
Mild TR
Impaired LV Relaxation
No PDA
No Coarctation of Aorta
Left Aortic Arch
No Pericardial effusion
Diagnostic & Comments:
Normal LV Systolic Functions
Impaired LV Relaxation
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It basically means that the function of the left ventricle of the heart has some measure of impairment. The wall of the ventricle tends to thicken and this affects function of the ventricle. If I am interpreting this report correctly, yours is at a mild stage.
Heart problems are extremely common in thal majors and related to high iron loads, as you had in the past, and anemia. It is essential to keep your iron load low, as it is now, and to also not let your Hb slip. It should always be kept above 9-9.5. Higher Hb means less work for the heart. I would also suggest you increase your intake of foods that promote nitric oxide formation in the body. These include many fruits like melon and blueberries. Google to learn more. I would recommend that you take L-carnitine or L-arginine daily, as they promote NO. You should be able to get these through GNC. NO gets depleted in thals and causes loss of elasticity in the pulmonary artery and the circulatory system, forcing the heart to have to work too hard to pump blood. I recommend L-carnitine etc to all thals as they age for this specific reason. You cam stop this from progressing and possibly reverse it by keeping iron low,
keeping Hb high and getting enough nutrients.
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Hi,
What is the LVEF%?
Are you on chelation as your fe is low?
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Andy,
thank you for the detailed reply .... i am struggling with both iron and Hb since last couple of months,, but didn't get ride over both issues till now :/ .... i wll surely follow the advise you gave ...
btw, the cardiologist who done ECG prescripted me "Carvedilol",, is this a high potency drug for heart dysfunction ???... why he prescripted me this kind of drug ???
and what about this ??
People with severe hepatic impairment are also not advised to take carvedilol.
Hanumant ,,
Left ventricular ejection fraction (LVEF) is the measurement of how much blood is being pumped out of the left ventricle of the heart (the main pumping chamber) with each contraction.
i m on Deferiprone sine last 4-5 years when my Ferritin was 252.... desferal with blood transfusion only ....
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Umair,
If your iron has increased you should increase your chelation to a more appropriate dose until it comes down again.
The Oakland centre has done large studies with L-carnitine and they have found it to be very beneficial in preventing and improving LVF. I think L-arginine may have the same protective function as it may be a precursor of L- carnitine (not sure...).
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sharmin,
according to my last S.Fe report my Fee was 783.... i think ,, its high but not high to create complication and problemes.... maybe its an indication/sign that iron being stored in organs and organs have more deposit of iron than blood :s ...
i will surely start L-carnitine etc ,,, once after consulting/discussing whether to take it with his prescripted medicine (carvidilol) or to take it alone or discontineu carvedilol....
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The drug is prescribed due to your recent episode. It is used in thalassemia.
http://www.ingentaconnect.com/content/ben/chamc/2012/00000010/00000001/art00005?crawler=true
Beta Blockers
The use of beta blocker especially Carvedilol is now a
standard part of therapy for other forms of heart failure.
They are indicated in thalassaemic heart disease when
excessive tachycardia is present.
Of course, I would prefer to see you continue your progress through chelation and nutrients. It is well known that damage to the heart from iron is reversible. I would stress high antioxidants and L-carnitine or L-argine. I'm not sure I agree with a drug approach when you have had only one incident.
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Andy,,,
Natural Vitamin-E 400mg ,, Zinc 50mg, vitam-A & D (100% DV) ,,, Osteocare-Plus ,,, Silliver-2000mg (silymarin) and GNC's Milk thistle 200mg .... and since last more than 3 months i m taking puritan's IP6-500mg twice a day on empty stomach... 2G Desferal with every transfusion ...
its not the 1st incident but the 1st longest one ,, in past it never been last long for more than a few minutes.. or mayb its 1st recorded 1, and i never paid enough attention to unusual heartbeat :D ...
do you think T2* MRI would be a helpful option to figure out the real situation ???
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I dont know why I was away either Umair. But now I need my family from thalpal so I am back.
How are your pulse issues now?
Kind regards, always.
a post from the past,, ( back in 2011) ,, just after coping with iron overload ,, and getting my Fe level below 500...
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Andy,
thank you for the detailed reply .... i am struggling with both iron and Hb since last couple of months,, but didn't get ride over both issues till now :/ .... i wll surely follow the advise you gave ...
btw, the cardiologist who done ECG prescripted me "Carvedilol",, is this a high potency drug for heart dysfunction ???... why he prescripted me this kind of drug ???
and what about this ??
Hanumant ,,
i m on Deferiprone sine last 4-5 years when my Ferritin was 252.... desferal with blood transfusion only ....
Nice Friend,
I asked the LVEF% Score and not the meaning of it.
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Hi,
carvedilol is very common drug used in thalassaemia. i am too taking metoprolol and ramipril.
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Andy,
thank you for the detailed reply .... i am struggling with both iron and Hb since last couple of months,, but didn't get ride over both issues till now :/ .... i wll surely follow the advise you gave ...
btw, the cardiologist who done ECG prescripted me "Carvedilol",, is this a high potency drug for heart dysfunction ???... why he prescripted me this kind of drug ???
and what about this ??
Hanumant ,,
i m on Deferiprone sine last 4-5 years when my Ferritin was 252.... desferal with blood transfusion only ....
Defripron with low ferritin will definitely destruct ur RBCs consequently u have to transfuse more and more blood. Check ur Retic count.
In addition desferal on BT day, is IV or SC ?
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Andy,,,
Natural Vitamin-E 400mg ,, Zinc 50mg, vitam-A & D (100% DV) ,,, Osteocare-Plus ,,, Silliver-2000mg (silymarin) and GNC's Milk thistle 200mg .... and since last more than 3 months i m taking puritan's IP6-500mg twice a day on empty stomach... 2G Desferal with every transfusion ...
its not the 1st incident but the 1st longest one ,, in past it never been last long for more than a few minutes.. or mayb its 1st recorded 1, and i never paid enough attention to unusual heartbeat :D ...
do you think T2* MRI would be a helpful option to figure out the real situation ???
T2* MRI is must for you.
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Umair,
Quite honestly, L-carnitine - or L-arginine should not have any contraindications with any other drugs. In Oakland the doctors routinely put patients on these supplements and they have found many many benefits.
They constantly endorse L-carnitine and zinc.
I wonder if doctors outside of the comprehensive clinics are aware of the benefits of these supplements to the degree that the Oakland doctors are. Dr. Ashutosh Lal in Oakland did a comprehensive study on these supplements.
I hope you are able to completely reverse any damage my friend,
:hugfriend
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Hanumant,
Nice Friend,
I asked the LVEF% Score and not the meaning of it.
oh ok ,,, my mistake :grin ....my EF% and FS% is within the normal ranges .... EF% ,, normal range 50-70%,, my result 64% .... FS% ,, normal range 29-37% ,, my result 35% ....
its a relief to hear that its a commmon drug in thalassemia ,, but what i think is, using a common drug doesnt mean that the probleme isn't alarming :S (for e.g if heart attack bcome common it doesnt mean that isnt something to worry about :S) ,,, i m confused ,, what do you say about it ??...
S.Fe and RB:: according to my last S.Fe report my FE was 783 in october-2015.... what is the test name for REtic Count
Desferal with BT:: IV ...
Sharmin,,,
I wonder if doctors outside of the comprehensive clinics are aware of the benefits of these supplements
it is the main probleme ,, here in pakistan NO doctor even know the names of IP-6 and milk thistle ,,, once i asked to a doctor should i try L-Carnitine but he "No" ,,, i wonder why said No because i know it is beneficial for thals to many aspects .... anyways now i will ask about it to my doctor too... its a great bad-luck that docs here in pakistan not aware of most of the supplements and benefits of those supplements ,, that is the reason why they hesitate to even allow (i m not talking about prescriting).... :/
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If u want to get rid of heart medicine
get ur T2* Cardiac MRI done ASAP
Though ur 2D echo lvef% is normal but it doesnt gaurantee that ur heart do not contain iron
in case of severe iron overload in heart the function of heart mostly remain intact.
using iv with bt is advisable only if u run the iv for 24 hours atleast +
with minimum iv fluid less than 250 ml.
disadvantage of iv is that it will surely cause hemolysis consequently higher blood tx
why dont u take SC desferal weekly once?
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Umair,
If this was only one isolated incident, is this drug really necessary? You had an extremely high iron load that was sure to affect your heart. Your heart will continue to get stronger as long as the iron load is kept under control. I don't know if intervention with drugs is needed.
L-carnitine is found in every cell in the body. It is quite safe to take normal doses, under 5 mg daily.