Enlarged Heart

[lilmhzj]

Dr. Fett,

How long does it take for the heart to enlarge due to Cardiomyopathy?
My heart was already enlarged upon diagnosis and I'm wondering how long I could've had
the condition without knowing it. My son was born August 19, 06, symptoms
(shortness of breath and coughing) started about the 1st or 2nd week of December 06
(4 mos Post Partum) and Diagnosis was on January 5, 2007. I have an enlarged heart,
EF of 20-25% at the time and fluid was building up in my lungs. I'm happy to say I'm no
longer coughing and the shortness of breath has improved!
I hope my next echo will show promise.

Janet

[JAMESFETT]

Your next echo will show promise since you no longer have the cough nor as much shortness of breath with exercise, and you are on both ACE-I and B-B, medications that not only help the ciruculation and pumping motion of the heart, but also are effective at stopping in its tracks the process that causes PPCM, which appears (strong support for this hypothesis) to be an overheated immune response in what may have started as a virus infection. When PPCM is beginning, first comes left ventricular systolic dysfunction (lowering of EF), followed at varying intervals by left ventricular enlargement. What was the size of your left ventricle on first echo, and what is your height and weight, so that I can calculate your body surface area and relate that to the size of the left ventricle, if you give me the EDD and ESD measurements on the first echo? For the process by which this develops I suggest you look at the diagram and schema in our article found in the International Journal of Gynecology and Obstetrics 2005;90:161-66. The speed at which this process develops can be fast or slow; in your case it was somewhat slow because your symptoms started 3+ months after delivery. When the process is faster, symptoms come on in the last month of pregnancy, if not sooner. Now, as you work with your excellent physician(s), it will be important to very gradually titrate upward your B-B and ACE-I as tolerated and as guided by followup echo, the first followup echo will hopefully happen between 2 to 4 weeks post diagnosis.

James