Brief Answer:
Lets understand the report first and then discuss the idea of surgery

Detailed Answer:
Hi there, thanks for coming to HealthCareMagic.

I'm going to try and break down your report for you line by line and then give you my thoughts on whether surgery would be a good option for you.

Report says "LEFT VENTRICLE: No focal wall motion abnormality. There is left ventricular outflow tract partial obstruction/severely turbulent flow and acceleration consistent with gradient; this appears to be arising below the aortic valve/outflow tract with appearance of tissue band along the anteroseptal cavity extending towards the junction of aortic outflow and medial mitral annulus or medial leaflet."

So here the ECHO is saying that the left ventricle of the heart is moving normally when it contracts during the heart beat. That's important to know because it shows that the heart is capable of pumping blood out of the heart with normal strength and volume.

They HAVE picked up an anomaly in the aorta and part of the heart though. There is a tough to see thickening of the aorta and heart that is preventing the blood from getting ejected from the left ventricle in a smooth and efficient manner. This could have long term ramifications or your health.

The turbulent blood flow and acceleration gradient MIGHT cause stress on the heart and enlarge the ventricle in the future. I stress MIGHT because further testing is needed before we can see this anomaly in detail and only time can tell if the excess energy needed to eject the blood normally will thicken the wall of the heart.

Study says "Study limitations do not allow better delineation of origin or attachments of this structure. Question mild bowing of mid segment of anterior mitral leaflet without malcoaptation or more overt systolic anterior motion."

An ECHO is not always the best way to LOOK at structures in the heart, it uses sound waves to make a slightly fuzzy picture of the heart in real time. The real time part is what is most useful during an ECHO because that allows us to look at the FUNCTIONING of the heart and how the blood is being pumped. The examiner has mentioned that there may be a problem with structure of the Mitral Valve. That's the valve that separates the top of the heart (The Atrium) from the bottom of the heart (the Ventricle) on the left side. Right after that though, they say that the FUNCTION of the mitral valve is just fine. No blood is being regurgitated BACK from the ventricle into the Atrium.

To look at that MITRAL valve a bit better, they have recommended a TransEsophageal ECHO. In that, the probe that creates the sound waves is inserted under sedation into your food pipe, that's the best way to get a good look at the Mitral Valve using an ECHO.

So all in all.. the report shows some STRUCTURAL abnormalities on the left side of your heart.. but it stresses that the FUNCTIONING of your heart is just fine.

So, now lets discuss this.

Your heart is pumping (FUNCTION) just fine, blood is getting out of your heart and to the rest of the body just fine. But there are STRUCTURAL abnormalities that they have seen.

Now, the 64 thousand dollar question is "Do we need to do anything about it?"

Over time, the structural problems could lead to a functional one, and as you age, your heart MIGHT need to work harder to keep functioning well. This is a bad deal, because the older you get the harder it is for the body to tolerate surgery to fix this in general.

On the flip side, should we risk surgery now to correct this.

In my opinion, we don't have enough information to answer this right away. A Cardiac MRI would probably get us more information, That TransEsophageal ECHO would give really useful info too.

Finally, a good Thoracic surgeon is the person who you would go to to get this surgery done, if at all. So you need to find one whom you gel with and discuss these findings with them. Get 2 opinions if you can. I would.

So there you go. Its a tricky situation, but at least I hope I managed to help you understand whats going on with that report. Set me straight if I messed up somewhere or have missed something and I'll fix it.

I look forward to your thoughts,

Vinay

---

Brief Answer:
Thanks for the correction, no blood flow problems right now.

Detailed Answer:
Hi, thanks for the follow-up. Sorry about my confusion in the reporting. I see you've already gotten the MRI done. That makes the TransEsophageal ECHO a good idea in my mind.

Now, "Is the blockage causing problems?". That turbulent flow and acceleration gradient I mentioned earlier are being caused by the blockage. That's a problem. But your heart has been able to overcome the problem to supply blood to the rest of the body with no loss.

"Is this a very bad problem?" My answer is "Not right now"

Your left ventricle seems to be able to cope with the obstruction in its current state (it's compensating well). If it wasn't able to cope well, it would thicken and the movement of the wall would be abnormal.

I can't really say if all of this will remain the same into the future. It will require regular checkups (monitoring) for sure.

I do not think that there will be any problems over the next couple of weeks, so you can calmly wait until you see your doctor for a face to face discussion.

Make sense? Let me know what you are thinking.

Vin

---

Brief Answer:
Always Happy To Help!

Detailed Answer:
Take care of yourself my friend. Will be here if you need me.

Vin

---