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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have had mild heart attack. What does Aniogram and Echo reports indicate?

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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6728 Questions

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Posted on Wed, 4 Dec 2013 in Hypertension and Heart Disease
Question: Hi, My father(age 55) has had a mild heart attack 4 days back. Angiogram and echo 2D(cardio) were done so far. Due to upload limit, i couldn't attach the Angiogram images I have given below the echo(2D) report details. Could you please help me understanding this report ? 2D Echo Regional wall motion abnormality+ Hypokinetic apical septum, Inferior Wall, Posterior wall, Posterio lateral wall Moderate LV Dysfunction LVIDd = 5.3 cm LVIDs = 4.4 cm EDV = 124 ml ESV = 91.1 ml no pericardial effusion no clot LVEF = 40% Color Doppler: MILD MR NO AS/AR Impression: Ischemic Heart Disease Moderate LV Dysfunction Mild MR No Pulmonary Hypertension
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Answered by Dr. Indu Kumar 1 hour later
Brief Answer: Ejection fraction is abnormal and he need medicine Detailed Answer: Hello Thanks for writing to XXXXXXX ECHO is colour sonography of heart which is done in real time. Findings of ECHO abnormality is due to recent myocardial infarction(Heart attack). It shows that there is regional abnormal movement of heart.This is due to involvement of this region during heart attack. There is also sluggish movement of septal region,inferior Wall, posterior wall and Postero lateral wall of heart.It is due to sequel of heart attack.Heart attack causes damage of muscles of heart and mentioned abnormality is due to this. At this time our main concern is ejection fraction,which is not satisfactory.It is below normal level.Normal ejection fraction is 55% or above.Decreased ejection fraction is due to LV(Left ventricular) dysfunction. There is mild mitral regurgitation also.There is no pericardial effusion or clot.There is also no aortic stenosis,aortic regurgitation or pulmonary hypertension. You shouldn't be paniky.Your father should follow cardiologist advice.Situation can be managed with medicines.There are different medicines to augment heart contractility and he needs these medicines regularly. Diet and life style should be followed according to advice.Other medicines for hypertension and diabetes mellitus should be continued. Get well soon Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Indu Kumar 14 minutes later
Hi, Thanks for the response. As per the Angiogram report, there are 3 blockages in the RCA part. So, cardiologist have suggested to go for a open-heart(by-pass) surgery as soon as possible. So i'm wondering whether the Echo(2D) report above indicate any sort of emergency? also do you see any other option other than by-pass surgery?
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Answered by Dr. Indu Kumar 27 minutes later
Brief Answer: Angiography is needed for coronary vessels status Detailed Answer: Hello Thanks for writing back ECHO shows functional status of heart,blood flow in chambers etc.It is preliminary test in cardiac investigations. It doesn't tell the underlying cause of ischemia and degree of blockade in coronary vessels(vessels that supply blood to heart muscles). Coronary vessels status is best determined by angiography,which is already done in your father's case. You should follow your doctor's advice and if there is severe degree of block in coronary vessels then By pass surgery is the only choice.If condition is not treated immediately then his life may be in danger.You can go with your cardiologist.Cardiologist is the best person to guide. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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