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What Does This Transesophageal Echocardiography Report Indicate?
Question: My mother had a transesophagal echo and some of the results were concerning. Her is what was reported:
1) left atrial appendage is bilobed with spontaneous echo contrast with no visualized thrombus
2) biatrial enlargement
3) shunt across atrial septum consistent with iatrogenic AS (post septal puncture)
4) mild mitral regurgitation
5) mild/moderate tricuspid regurgitation
6) grade 3 atheroma disease of aorta (consistent with sessile (<4mm)- maximal plaque thickness was 3 mm
Also, can I add she does have afib which she is trying to get under control
Is there any of these that seem concerning, and is there anything that can be done to improve or slow the progress of these conditions?
Thank you.
1) left atrial appendage is bilobed with spontaneous echo contrast with no visualized thrombus
2) biatrial enlargement
3) shunt across atrial septum consistent with iatrogenic AS (post septal puncture)
4) mild mitral regurgitation
5) mild/moderate tricuspid regurgitation
6) grade 3 atheroma disease of aorta (consistent with sessile (<4mm)- maximal plaque thickness was 3 mm
Also, can I add she does have afib which she is trying to get under control
Is there any of these that seem concerning, and is there anything that can be done to improve or slow the progress of these conditions?
Thank you.
Brief Answer:
Her basic abnormality is Atrial Fibrillation
Detailed Answer:
Hi There
After going through the Transesophageal Echo report I understand your concern for your mother's health, am Dr Bhanu partap and I am a cardiology practitioner. I would try to explain things in a simple and pointwise manner.
1. Spontaneous Echo contrast is formed when the flow of blood is slow in the heart chambers as in the patients of AF. The good thing here is that there is no thrombus in the LA appendage.
2. Biatrial enlargement is due to AF because in this the atria loose their contraction ability to push the complete amount of blood into ventricle due to which extra amount stays there leading to enlargement.
3. Shunt they have mentioned to be iatrogenic which means she have underwent some procedure in the past which might have required the septum to be punctured creating a small shunt there.
4. Mitral and Tricuspid regurgitation are usually due to age related degeneration that happen in the body. These also contribute to atrial enlargement by supplying extra amount of blood.
5. Atheromatous disease is aagain a age related degeneration of aorta.
These all are the consequences of ATRIAL FIBRILLATION as well as age related degeneration.
So what needs to be taken care is that she should continue with her ongoing meds very regularly especially the anticoagulant medication like WARFARIN. As this helps prevent clot formation in heart there by preventing the STROKE.
I hope this information will answer your query. If you have any doubt you can ask me back or else you can close the discussion and kindly rate the answer.
I wish her good health
Her basic abnormality is Atrial Fibrillation
Detailed Answer:
Hi There
After going through the Transesophageal Echo report I understand your concern for your mother's health, am Dr Bhanu partap and I am a cardiology practitioner. I would try to explain things in a simple and pointwise manner.
1. Spontaneous Echo contrast is formed when the flow of blood is slow in the heart chambers as in the patients of AF. The good thing here is that there is no thrombus in the LA appendage.
2. Biatrial enlargement is due to AF because in this the atria loose their contraction ability to push the complete amount of blood into ventricle due to which extra amount stays there leading to enlargement.
3. Shunt they have mentioned to be iatrogenic which means she have underwent some procedure in the past which might have required the septum to be punctured creating a small shunt there.
4. Mitral and Tricuspid regurgitation are usually due to age related degeneration that happen in the body. These also contribute to atrial enlargement by supplying extra amount of blood.
5. Atheromatous disease is aagain a age related degeneration of aorta.
These all are the consequences of ATRIAL FIBRILLATION as well as age related degeneration.
So what needs to be taken care is that she should continue with her ongoing meds very regularly especially the anticoagulant medication like WARFARIN. As this helps prevent clot formation in heart there by preventing the STROKE.
I hope this information will answer your query. If you have any doubt you can ask me back or else you can close the discussion and kindly rate the answer.
I wish her good health
Above answer was peer-reviewed by :
Dr. Remy Koshy
For #5, it says grade 3 and plaque thickness 3 mm. Is this bad, and what happens when it turns into grade 4? She did have ablation in December but afib came back just recently.
Brief Answer:
Patients usually are asymptomatic till stage 6
Detailed Answer:
Aortic atherosclerosis is divided in 8 grades. Third grade is preatheroma stage and fourth is Atheroma proper.
Measures that can be taken to reduce the progress of the disease includes lifestyle modifications which am gonna mention here:
Many approaches have been promoted as methods to reduce or reverse atheroma progression.
eating a diet of raw fruits, vegetables, nuts, beans, berries, and grains,
consuming foods containing omega-3 fatty acids such as fish, fish-derived supplements, as well as flax seed oil, borage oil, and other non-animal-based oils;
abdominal fat reduction;
aerobic exercise.
Medication like STATINS also helps in slowing the progress.
micronutrient (vitamins, potassium, and magnesium) consumption.
maintaining normal, or healthy, blood pressure levels.
Once the AF reverts after ablation, two options are there either the cardiologist can advise for a second ablation or just keep the focus on rate control measures accepting the presence of AF.
I hope this will answer your query.
Regards
Dr Bhanu Partap
Patients usually are asymptomatic till stage 6
Detailed Answer:
Aortic atherosclerosis is divided in 8 grades. Third grade is preatheroma stage and fourth is Atheroma proper.
Measures that can be taken to reduce the progress of the disease includes lifestyle modifications which am gonna mention here:
Many approaches have been promoted as methods to reduce or reverse atheroma progression.
eating a diet of raw fruits, vegetables, nuts, beans, berries, and grains,
consuming foods containing omega-3 fatty acids such as fish, fish-derived supplements, as well as flax seed oil, borage oil, and other non-animal-based oils;
abdominal fat reduction;
aerobic exercise.
Medication like STATINS also helps in slowing the progress.
micronutrient (vitamins, potassium, and magnesium) consumption.
maintaining normal, or healthy, blood pressure levels.
Once the AF reverts after ablation, two options are there either the cardiologist can advise for a second ablation or just keep the focus on rate control measures accepting the presence of AF.
I hope this will answer your query.
Regards
Dr Bhanu Partap
Above answer was peer-reviewed by :
Dr. Remy Koshy
Sorry two final questions. Is plaque thickness (3mm) a concern? Also, if it should get to one of the higher grades, is surgery done to correct?
Brief Answer:
Hello again
Detailed Answer:
It's totally fine, please don't be sorry.
As of now it's not a concern but we should bear it in mind that it's there and it's gonna progress if we don't take necessary precautions which I have mentioned before ( lifestyle modifications ).
Yes if in coming years it progress then it needs to be corrected by surgery but the rate of progression is generally very slow in majority of the patients.
Go for a follow up echo yearly.
Regards
Dr Bhanu partap
Hello again
Detailed Answer:
It's totally fine, please don't be sorry.
As of now it's not a concern but we should bear it in mind that it's there and it's gonna progress if we don't take necessary precautions which I have mentioned before ( lifestyle modifications ).
Yes if in coming years it progress then it needs to be corrected by surgery but the rate of progression is generally very slow in majority of the patients.
Go for a follow up echo yearly.
Regards
Dr Bhanu partap
Above answer was peer-reviewed by :
Dr. Remy Koshy
She has been experiencing heart palpitations and jump in blood pressure (160-170s) when lying down? Also, when we check her pressure on the home bp machine, its still showing the flashing heart symbol indicating abnormal rhythm (I think). Is this a need for concern? She goes for her ekg friday, but I was thinking maybe we should try to go sooner. Finally, is is better to take ace inhibitors, beta blockers, in morning or at night? Thank you.
Brief Answer:
Hello again
Detailed Answer:
1. Most of the Bp monitors which are used at home are not that sophisticated to judge heart rhythm so may be its just an animation. But yes you can go for an EKG early if she is not feeling comfortable.
2. Now regarding the intake of Anti hypertensive medicine, it's not like that they are good if taken in morning or at night. They are prescribed according to the patient requirements. So it's advisable to continue as advised by your treating cardiologist.
Regards
Dr Bhanu Partap
Hello again
Detailed Answer:
1. Most of the Bp monitors which are used at home are not that sophisticated to judge heart rhythm so may be its just an animation. But yes you can go for an EKG early if she is not feeling comfortable.
2. Now regarding the intake of Anti hypertensive medicine, it's not like that they are good if taken in morning or at night. They are prescribed according to the patient requirements. So it's advisable to continue as advised by your treating cardiologist.
Regards
Dr Bhanu Partap
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you for your reply. But why do think she is experiencing high blood pressure and palpitations when lying down?
Brief Answer:
Hello
Detailed Answer:
Her palpitations are due to the abnormal heart rhythm (AF) and she is hypertensive. These problems does not go away just by lying down.
Regards
Dr Bhanu Partap
Hello
Detailed Answer:
Her palpitations are due to the abnormal heart rhythm (AF) and she is hypertensive. These problems does not go away just by lying down.
Regards
Dr Bhanu Partap
Above answer was peer-reviewed by :
Dr. Remy Koshy
She is back in rhythm after being cardioverted again last Friday. I don't know I guess we will see what the ekg says and bring it up to her doctor tomorrow. Again Im sorry for all the questions, and I thank you for your prompt and well explained answers.
Brief Answer:
My Pleasure
Detailed Answer:
Yes it will be a good idea to get her physically evaluated by her treating doctor.
I wish her good health.
My Pleasure
Detailed Answer:
Yes it will be a good idea to get her physically evaluated by her treating doctor.
I wish her good health.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Remy Koshy
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