Echocardiogram Results

 

I had my meeting with my GP yesterday afternoon, to discuss the report from my echocardiogram on February 25th 25. I scanned in the hard copy (little is electronically joined up in today's NHS) and asked ChatGPT to summarise the report and its implications.

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Summary of Echocardiogram Report (25 Feb 2025)     ---    [ChatGPT]

Key Findings

Heart Rhythm: Sinus rhythm, resting heart rate 58 bpm, with rare ventricular extrasystoles.

Left Ventricle: Normal size, normal systolic function (ejection fraction 57%), no regional wall motion abnormalities.

Right Ventricle: Normal size and function.

Mitral Valve: Thickened, fleshy leaflets with bi-leaflet bowing, opening well. Mild to moderate mitral regurgitation (MR) (vena contracta = 0.37 cm).

Aortic Valve: Normal trileaflet structure, thin and mobile leaflets, no significant stenosis or obstruction.

Tricuspid Valve: Thin and mobile, mild regurgitation, no signs of pulmonary hypertension.

Pulmonary Valve: Normal structure, trivial regurgitation.

Left Atrium: Normal size.

Inferior Vena Cava: Dilated but collapses less than 50% on sniffing (suggests mildly raised right atrial pressure).

No pericardial or pleural effusion.

Interpretation & Comments on Your Decision

1. Severity of Mitral Regurgitation

Your mitral regurgitation is mild to moderate, which is reassuring. In more severe cases, MR can lead to symptoms such as fatigue, worsening shortness of breath, and atrial fibrillation due to left atrial enlargement. However, your report suggests your heart function remains strong, and there’s no major impact on chamber size or overall circulation.

2. Implications of Mild to Moderate MR

Low immediate risk: Given your normal ejection fraction (57%) and the absence of significant left atrial enlargement or pulmonary hypertension, there’s no immediate concern.

Potential for progression: Mitral regurgitation can worsen over time, so monitoring symptoms is key. If breathlessness on exertion (SOBOE) worsens, a repeat echocardiogram in a year or two might be prudent.

Minimal impact on daily life: Your exercise tolerance may remain stable, though you should note any changes in fatigue, breathlessness, or irregular heartbeats.

3. Decision to Cancel the May Cardiologist Appointment

Your reasoning is understandable. The cardiologist would likely only suggest medications (e.g., beta-blockers, ACE inhibitors, diuretics) to reduce heart strain, and given the mild nature of your condition, these might not be necessary at this stage. You’re also right to consider quality of life—many cardiac medications come with side effects that may not be worth it for a condition that currently seems stable.

That said, if your symptoms progress (e.g., worsening breathlessness, palpitations, or fatigue), reconsidering follow-up in the future would be wise.

4. Recommendations Going Forward

Monitor symptoms: If you notice worsening exercise tolerance or arrhythmias, reassess.

Repeat echocardiogram: Consider one in 1–2 years to track any progression.

Lifestyle: Maintain heart-healthy habits (moderate exercise, balanced diet, hydration).

Blood pressure monitoring: Since low BP may play a role in your scotomas, keeping an eye on it is sensible.

Final Thoughts

Your echocardiogram is reassuring, showing only mild-moderate MR without major consequences. Your decision to avoid unnecessary medication is reasonable, provided you keep an eye on symptoms. If anything changes, a repeat scan in the future would be a logical step.

[I am booked in for a repeat echocardiogram in two years time.]

Diary: genetics + NHS screening + political correctness

1. Reading the rather good "Ancestors in Our Genome: The New Science of Human Evolution" by Dr Eugene E. Harris, Professor of Biology at the City University of New York. Based on whole genome analyses from diverse human populations, chimpanzees, gorillas and other apes and monkeys, what can be said about our recent evolutionary history? The right framework to think about this turns out to be population genetics. What follows is an extremely informative history of the last 20-30 years of human evolution research plus a very good conceptual overview of population genetics itself. I intend to write a much more detailed review once I've finished this book. (Update: read it here).

2. How many screening programmes does the NHS run for 'elderly men'? I'm already on the  faecal occult blood (FOB) test programme (as yucky as it sounds) and have been sent off for a colonoscopy (the link takes you to my diary of the experience). Today I received the invitation for abdominal aortic aneurysm screening which thankfully promises to be just an abdominal gel rub-down and an ultrasound scan: ten minutes. I will let you know. Google tells me that I've now run the gamut of age-appropriate screening.

3. Only in America department (from the New York Times via Steve Sailer who has the summarised story).

"Anna didn’t want to keep her feelings secret. As far as she knew, neither did D.J. In recent weeks, their relationship had changed, and it wasn’t clear when or how to share the news. ‘‘It’s your call,’’ she said to him in the lead-up to a meeting with his mother and older brother. ‘‘It’s your family. It’s up to you.’’

When she arrived at the house on Memorial Day in 2011, Anna didn’t know what D.J. planned to do. His brother, Wesley, was working in the garden, so she went straight inside to speak with D.J. and his mother, P. They chatted for a while at the dining table about D.J.’s plans for school and for getting his own apartment. Then there was a lull in the conversation after Wesley came back in, and Anna took hold of D.J.’s hand. ‘‘We have something to tell you,’’ they announced at last. ‘‘We’re in love.’’

‘‘What do you mean, in love?’’ P. asked, the color draining from her face.

To Wesley, she looked pale and weak, like ‘‘Caesar when he found out that Brutus betrayed him.’’ He felt sick to his stomach. What made them so uncomfortable was not that Anna was 41 and D.J. was 30, or that Anna is white and D.J. is black, or even that Anna was married with two children while D.J. had never dated anyone. What made them so upset — what led to all the arguing that followed, and the criminal trial and million-­dollar civil suit — was the fact that Anna can speak and D.J. can’t; that she was a tenured professor of ethics at Rutgers University in Newark and D.J. has been declared by the state to have the mental capacity of a toddler. …"

Anna has now been found guilty of sexual assault and - with sentencing is scheduled for Nov. 9 - could end up in the Edna Mahan Correctional Facility for Women for up to 40 years.

Ebola: should you be worried?

Just to the end of October 2014

That's the trouble with exponentials: they burble around beneath the noise floor - 1, 2, 4, 8, 16 - and then sixteen iterations later it's one million, two million, four million .. and you're overwhelmed.

Scientific American writes:

"In a worst-case scenario the CDC projected that by mid-January, Sierra Leone and Liberia alone could have up to 1.4 million cases."

Yes, mid-January .. and 1.4 million.

Dr James Thompson at UCL has been posting about this, the latest being his satirical "Ebola IQ test"

"Given a viral disease which is transmitted by contact with the contaminated bodily fluids of infected dying and dead people such that each case can lead to 2 new cases, and for which there is no known cure, though rehydration and basic nursing improve outcomes somewhat, which of the following is the best strategy to save the most lives?

"In each case, chose either A or B."

(continue reading)

The NHS could presumably handle what eluded the Spanish, the prompt isolation of a carrier followed by quarantine of all contacts. But this is highly labour-intensive (dozens of at-risk contacts); it's hard to see it working if we had a hundred belatedly-identified carriers. The UK, along with the rest of Western Europe, is densely populated and highly-interconnected by busy transport links. City-wide or regional quarantine would be difficult in the extreme, even if the political will could be found for the necessary military enforcement

If the Ebola exponential wildfire sweeps across Sub-Saharan African early next year, then the UK isn't just subject to the  threat of incoming air flights. Most likely the virus will burst out to the more adjacent Middle-Eastern or North African regions, and thence into Europe by a thousand routes.

At the moment, due to West African poverty and lack of development, the virus is moving slowly. Incursions into Europe have mostly been self-inflicted through the repatriation of infected health workers. However, if incursions become more organic and massive then all those complacent "We're protected," bets are off.

Time for that trip to town, to stock up on soups, bottled water and Campingaz cartridges. A shotgun would be handy too as you hunker down.

"Love thy neighbour" .. why, exactly?

The following observation (Richard Dawkins, The Selfish Gene) has always struck me as both profound and politically illuminating.

"For relationships as distant as third cousin (2 x (1/2)⁸ = 1/128) we are getting down near the baseline probability that a particular gene possessed by A will be shared by any random individual taken from the population."

The 'population' we are talking about here is the co-ethnic population. For example, English people whose grandparents on both sides were also English.

What would you think if you saw someone walking down the street greeting everyone they met with a warm smile and a cheery greeting as if they were meeting their brother or sister? I'd cross over! People at less than 1% relatedness don't stir any innate kin-altruistic feelings in us. And so to the tragedy of the NHS and other 'caring' bureaucracies. Apart from rare super-empathic individuals (aka 'saints') most staff don't have any emotional investment in their clients at all - and why should they? So the default mode is neglect - as on the street. People who create social policies are often smart, highly urbane and empathic individuals who implicitly believe the masses are just like them. Organisations, processes and laws are repeatedly designed as if no-one would ever try to game them for their own convenience. If only!

The other implication concerns your personal contribution to the gene pool. After eight generations your descendants will be no closer genetically to you than a co-ethnic stranger today in the supermarket. So stop worrying about your spurious genetic immortality! But doesn't this contradict evolution? Not really: if the human race was today undergoing strong selection (i.e. lots of people were being killed off by the 'environment' before reproducing) then as a reproducing survivor your genes would disproportionally contribute, and skew, the future gene pool: they would matter. However, in advanced countries humanity today is subject only to weak selection - the gene pool is 'stationary' - so your contribution really doesn't matter at all.

Small caveat: if you're intelligent and civilised and don't reproduce, be aware that the rather dim and less civilised are reproducing just fine: they don't have the distractions of interesting career options. This of course also steers the gene pool so it's not quite stationary.