Dilated left atrium and diastolic dysfunction, stage 3.. what was it?

Question

It's been 2 years ago when I was diagnosed to have such heart problem, but just recently, my doctor said that I am OK.

However, I still feel chest tightening mostly at about 3am to 5am, and it awakens me in my sleep. Should I ignore it or is it just normal for a 49 year old like me. What shall I do?

By the way what have caused my illness. We have no history of heart disease in the family.

Answer 1

Let's go item by item -

Dilated left atrium. The atria are the chambers on top of the heart. Their job is essentially to fill the ventricle. The question is why would the atria be dilated? It could be a valvular disorder (like mitral regurgitation or mitral stenosis) which you didn't mention. It is also possible you may have elevated pulmonary pressures too - blood flow around your lungs, but that usually manifests in dilated right ventricle too.

Diastolic dysfunction is a condition that develops as a response to either your heart beating too fast or poorly controlled blood pressure over a significant time - a decade. It is a failure of the left ventrical to relax fully and fill with blood. Diastolic dysfunction can lead to congestive failure (fluid in your lungs making it difficult to breathe) and can be rather debilitating - limiting exercise capacity, etc. One third of all congestive failure hospital admissions is due to diastolic dysfunction.

Stage 3 - Hmm. I suspect it is on the scale of heart failure. If so, it is equal to someone being winded with mild activity. As opposed to stage IV which is winded at rest. Or stage II which is winded with moderate activity.

Based on all of the information provided - there is one single thing that comes to mind: sleep apnea. Have you been evaluated by a sleep study and are you fitted for equipment?

This probably is not heart disease in the traditional sense. It is probably not blockages in your coronary arteries causing angina or worse heart attacks.

The chest pain could be from a variety of things, but I would not ignore it. And if you are not treated for apnea, your blood pressure is not ideally controlled (systolic less than 120 - always) or your heart rate is commonly over 85 then there is work yet to be done. You may also benefit from a stress test - talk it over with your doctor.

Best to you. Be well.

Answer 2

To receive a diagnosis like you describe above, I would be leary of my new diagnosis without further testing/followup.

Also, I don't think you should ignore the fact that you are awaken at night from your sleep with those symptoms. They may be nothing, but the initial diagnosis has me puzzled. If it were me, I would go to another cardiologist and get a second opinion.