Is a left ventricular end diastolic diameter of 65mm considered severe

A left ventricular end diastolic diameter of 65 millimeters is considered significantly enlarged, usually indicating impaired cardiac function. Left ventricular enlargement may be caused by factors such as hypertensive heart disease, dilated cardiomyopathy, valvular heart disease, ischemic cardiomyopathy, long-term anemia, etc. It needs to be comprehensively evaluated in combination with clinical symptoms and other echocardiographic indicators.

1. Hypertensive heart disease:

Long term uncontrolled hypertension can lead to compensatory hypertrophy and dilation of the left ventricle. When the end diastolic diameter of the left ventricle exceeds 60 millimeters, the myocardial contraction efficiency decreases, and there may be post activity dyspnea and nocturnal paroxysmal dyspnea. Treatment requires strict pressure control, with commonly used medications including valsartan and amlodipine, while limiting sodium intake.

2. Dilated cardiomyopathy:

Primary myocardial disease leads to significant enlargement of the ventricular cavity, with 65 millimeters already in the moderate dilation stage. Patients often have arrhythmia, lower limb edema, and overall wall motion is weakened on ultrasound. Beta blockers such as metoprolol combined with diuretics should be used for treatment, and cardiac resynchronization therapy should be considered for severe cases.

3. Valve disease:

Aortic valve regurgitation or mitral regurgitation can cause left ventricular volume overload. Dilation of 65mm is often accompanied by moderate to severe valve disease, and characteristic murmurs can be heard on auscultation. Mild lesions can be relieved with diuretics, while severe reflux requires valve repair or replacement surgery.

4. Ischemic cardiomyopathy:

After myocardial infarction, ventricular remodeling leads to left ventricular enlargement, with a 65 millimeter mark indicating a larger infarct area. These patients often have a history of angina pectoris and delayed enhancement lesions can be seen on cardiac magnetic resonance imaging. The treatment requires revascularization combined with anti remodeling drugs such as sacubitril and valsartan, and surgical resection is required when ventricular aneurysm formation occurs.

5. Long term anemia:

Chronic severe anemia causes compensatory increase in cardiac output, leading to ventricular dilation over time. When hemoglobin is below 60g/L, there may be a 65mm dilation accompanied by pale complexion and fatigue. After correcting anemia, the heart may partially retract due to enlargement, and it is necessary to supplement hematopoietic materials such as iron and vitamin B12.

It is recommended to monitor blood pressure and weight changes daily, and control daily fluid intake within 1500 milliliters. The diet adopts a low salt and low-fat formula, with priority given to foods rich in omega-3 fatty acids such as steamed fish and oats. Avoid vigorous exercise but maintain 30 minute brisk walking exercises 5 times a week. Elevating the head of the bed by 15 degrees during sleep can reduce nighttime breathing difficulties. Regularly review echocardiography to evaluate cardiac function, and seek medical attention immediately if new chest tightness or decreased urine output occurs.