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Eco test showed situs sollitus, AV and V-A concordace and RA. Looking for proper diagnosis and advice?

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General & Family Physician
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Eco test report:- Situs sollitus, AV& V-A concordace, RA,RV dilated other chamber normal; Normaal LV systolic & diastolic function, Large2'ASD 3.3cm, deficient margian on SVC,IVC, Pulvenous, No VSD or PDA; MOd. TR,(RVSP33 +RAP); NO AR/MR; No clot/vegetation/Pericardial effusion. Please diagnose & advise. Thanks! XXXXXX New Delhi. Email:- YYYY@YYYY
Posted Sun, 14 Oct 2012 in X-ray, Lab tests and Scans
Answered by Dr. Michelle Gibson James 1 hour later

Situs solitus-this term means normal position of thoracic and abdominal organs.So on the echo the heart was located in the correct position and its chambers were also positioned correctly.

Av and VA concordance- the heart is divided normally into a right and left side each side has upper and lower chambers. The upper chambers are called atria and the lower chambers are called ventricles. So each person is suppose to have a right atria which connects to the right ventricle and a left atria which connects to a left ventricle.
AV concordance means that the right atrium is connected to the right ventricle and the left atria to the left ventricle (this is normal)
VA concordance refers to the blood vessels coming from the right and left ventricles, concordance means the right vessel is coming from each ventricle.

RA (right atrium), RV (right ventricle) - dilated - these chambers are enlarged , they state that the other chambers are normal.

Normal LV (left ventricle) systolic and diastolic function- systolic refers to the heart (left ventricle is the part that receives blood from the lungs and sends tothe rest of the body) contracting to send the blood to the rest of the body and diastolic refers to relaxation of the heart when receiving blood from the lungs.The echo states that the contraction and relaxation is normal.

ASD- atrial septal defect means that there is a defect or hole in the wall between the left and right atrium.This results in a mixing of blood which may or may not be significant.Once this is detect the cardiologist and cardiac surgeon determine whether or not it needs to be closed. Normally before attempting closure the cardiologist will check to see if the pressure in the lungs is high. Sometimes in atrial septal defect there is increased blood going to the lungs (normally blood goes from the right ventricle to the lungs and if there is a connection between the RA and LA there will be increased blood going towards the lungs from the right ventricle). Increased blood to the lungs can sometimes lead to increased pressure in the lungs called pulmonary hypertension.

Deficient margin on SVC (superior vena cava), IVC (inferior vena cava)-the ASD is classified according to the type of defect. There is a type that can involve the blood flowing through the inferior or superior vena cava

No VSD (ventriculo septal defect- no hole in the wall between the two ventricles) ,no PDA-patent ductus arteriosus- another heart defect that can occur, it was not seen

TR- tricuspid regurgitation- this means that when the heart is contracting some of the blood in the right ventricle goes back into the right atrium because the conection between them does not close properly. It may have resulted from the enlargement on the right side of the heart, treatment usually involves treating the underlying cause.

RSVP refers to the right ventricular systolic pressure- it was done to check to see if you had pulmonary hypertension (high pressure in the lungs).A value more than 35 raises concern that pulmonary hypertension is present, yours was 33 so it was less.

No MR - mitral regurgitation or AR (aortic regurgitation)- these are other heart defects that were not seen when the echo was done.

No clot/vegetation - no clots or vegetation( growth) on any of the heart valves- this is good.
No pericardial effusion- no fluid around the heart

Your cardiologist will likely discuss the possibility of closure of the atrial defect.

I hope this information is helpful, feel free to ask any other questions
Above answer was peer-reviewed by
Follow-up: Eco test showed situs sollitus, AV and V-A concordace and RA. Looking for proper diagnosis and advice? 9 hours later
Hello DR,

What type of precaution will be taken, what is right way of diagnose or treatment & prognosis , can that remove with the help of medicine, need of angiography & revascularization. Please advise !

Answered by Dr. Michelle Gibson James 7 hours later
Hi, your cardiologist may have suggested the echo to evaluate the ASD and determine if there was any evidence of pulmonary hypertension.
The ASD can be surgically repaired if you are experiencing symptoms, some doctors and patients also decide to do surgical repair to reduce the chances of pulmonary hypertension occuring if not already present even if there are no symptoms at the moment.

Prognosis depends on the symptoms, the development of pulmonary hypertension.
Angiography and revascularization is done if someone has a blockage of an artery from high cholesterol and that is not shown here. If you do have high cholesterol, have symptoms related to blockage of blood vessels in the heart then your doctor may suggest angiography to look at the blood vessels, if they are blocked then revascularisation (opening of the blood vessels) is done.

You should consider speaking to your cardiologist to decide the appropriate next step for you.
Feel free to ask any other questions
Above answer was peer-reviewed by
Follow-up: Eco test showed situs sollitus, AV and V-A concordace and RA. Looking for proper diagnosis and advice? 11 days later
Hello Dr. there is the Trans Esophageal Echo cardiography Report :-
Congential heart disease.
Large fossa ovalis ASD(34x266mm) with left to right shunt.
Absent aortic rim.
Deficient posterior inferior rim.
Grade 2/4 TR, PG=30mmHG.
Mild MR
Normal ventricular function.

Dr. please suggest what will we do now, what precaution will we take further, & what is the treatment.
Answered by Dr. Michelle Gibson James 34 minutes later

Large fossa ovalis ASD(atrial septal defect)- the previous echo stated that you had an atrial septal defect which is a hole in the wall between the left and right atrium.
The defects are usually defined in terms of the exact location, and fossa ovalis is just to indicate which aspect of the septum is involved.

When contemplating closure , the doctor must take a look at the rims of the defect, in addition to other factors such as the size of the defect.The rims are given different names according to their location hence the names aortic rim and posterior inferior rim.
Your doctor looked at the rims to make sure that they were adequate enough for closure with a device placed in the defect.If the defect cannot be closed in this way then it will be surgically closed and repaired.

The previous echo had also commented on the presence of tricuspid regurgitation.This echo states that there is also mild MR which is mitral regurgitation (there is a small amount of blood going from the left ventricle to left atrium).

Your doctor will likely discuss the results with you and will decide whether the rims are adequate to place a device or whether surgical closure is your best alternative.

I wish you the best
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