gradient improvement/medications

[wade]

Hello...I haven't posted since I was first diagnosed with HOCM (over a year ago). Since then I've been on Diltiazem (CC Blocker) 240mg once per day, and have seen some slight improvements in my echo results.
In particular, my peak gradient decreased from 27mmHg to 14.2, and septal measurement went from 2.6cm to 2.1 (over 12 months).

I'm not sure exactly what to make of this. Does anyone know of normal varience percentages between properly done echo exams? More importantly, has anyone had any personal experience with echo results improving as a result of medications?

Granted, these are just "numbers" and I still have the obstruction...but I'd like to think the meds are having a positive effect

Thanks!
Wade

[Sarah]

Dear Wade,

Glad to "see" you!

Well, medication often does reduce your gradient. However, it is not typical for the septum to reduce itself. Now, from time to time people report their echos have big changes in them but rarely are they downward. 2-3mm is a standard variance to expect between echos. 5mm is a teensy, tiny bit bigger than one would expect but not outside the realm of possiblitiy of being an error --especially if they were done by different echo labs (ie different hospital or doctor's office, etc).

I've read that Norpace is really great for reducing gradient, too.

Are you seeing a specialist? What does your doctor have to say about the echo? I recommend giving Lisa a call at 973-983-7429 as she can hook you up with a specialist if need be.

take care, and congrats on the gradient!

S

[wade]

Thanks Sarah! My doctor is pleased that my gradient has decreesed, but said not to read to much into the difference in septal thickness. I have read on this board that there is a specailist in my area, and my cardioligist would have no problem refering me there. He seems to have a pretty solid understanding of HCM, but I wouldn't mind also being checked out by an expert. I'll discuss it with him at my next appointment. Thanks again and keep up the good work on the site!
Wade

[Lisa Salberg]

A large factor in the changes in echo readings is hydration... if you are at all dehydrated while having an echo the #'s will tend to be higer and your gradient will be higher. This is one reason why creating a treatment plan takes time to customize.
Wade, looks like you lucked out here! Your meds are doing a great job...FYI it can take some people up to 3 years to find the best balance for themselves!
Be well,
Lisa