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What Do The Cardiac Ultrasound Results Indicate?

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Posted on Tue, 24 Oct 2017
Question: Hi can you please shed some light on this for me. (basic history) I had an PE in 1991 which needed surgery to remove I was already in a bad state after a RTA and 2 months later got the PE which was truly life threatening and changed my life drastically, I did recover some complications after the surgery including fluid around the lungs ( I think one collapsed when I had the PE) This was drained off, the fluid around my heart resolved once i got XXXXXXX Over the years I was always ill and really fatigued leading to a diagnoses of CFS/ME. I always had my doubts about this diagnoses as I believed it was linked to all the trauma and surgeries I had. Last year I got worse so done some research for my self which lead to me getting tested for sleep apnea and I was diagnosed with sleep apnea and given a CPAP machine. I then noticed my oxygen where still low during the day ranging from 90 to 96, So I was referred for more test on my respiratory system and heart. My lung function was 70% and showed some obstruction on the breathing test and was put on an inhaler. What I need help with is understanding my latest results from a letter of my heart as there appears to be some anomalies. Can you please take a look at this extract from the actual letter and explain it to me please. I'm looking for specific explanation of the two anomalies I think is in this letter, and are these anomalies caused by the PE I had as I believe they are, their is no family history of heart problems. I would like to know the percentage or in your professional view the likelihood that these are due to the PE I had. Can you tell me what it means long term for my heart health and any treatment that can be used for it, I would like to be prepared as much as possible for my follow up appoint which is over a month away! Extract below



I have the results of this gentleman's echo which was done to look for any CTEPH because of his previous PE with surgical embolectomy. i am pleased to say that his LV shows normal dimensions, ejection fraction estimated 59% with reduced longitudinal function. LA is normal dimension, no obvious valve problems, RA and RV are within normal dimensions and good contraction. Pulmonary artery systolic pressure is normal. PA and RV outflow tract appear mildly dilated. Therefore no evidence of CTEPH.
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again, dear xxxxxx

I would like to give some more explanations regarding your cardiac ultrasound findings as follows:

Your left heart chambers seems to be within normal ranges as stated, so there is no left heart cardiomyopathy.

Regarding your right heart chambers, as your right atrium and ventricle are within normal ranges and also right ventricle function is preserved a right heart cardiomyopathy is excluded. This conclusion is supported also by the fact pulmonary artery systolic pressure (PASP) is normal.

So, in conclusion CTEPH (chronic tromboembolic pulmonary hypertension) is totally excluded.

Your should relax and don#t worry about this issue.

What is recommended in this regards is to avoid any favoring factor for circulating blood stasis and pro-coagulation factors.

The most important is to control increased body weight and sedentary life-style.
Avoid close smoking contacts.

If you have a copy of your echo report, I would bee glad to directly review it here (you could upload it here).

Hope to have been helpful to you!

In case of any further questions, feel free to ask me again.

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (45 minutes later)
Thank you Dr Dr. Ilir Sharka

The reason i resubmitted the question is that the question had been closed, and I had another question about this. Thank you for giving more information on this too that has helped. My question is what does the "with reduced longitudinal function" part in the letter mean? I don't have a copy of the echo report but when i see the doctor in my follow up in November i will see if its possible i can get a copy

Best Regards
xxxxxxx
doctor
Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I would explain:

Detailed Answer:
Hello again,

Regarding the statement "reduced longitudinal function" I would explain that it comprises indexes of systolic and diastolic function (corresponding to contraction and relaxation phases of cardiac cycle) obtained by utilizing relatively new techniques such as Tissue Doppler techniques and newer ones such as strain and strain rate patterns (global longitudinal strain) by utilizing speckle echo.

When only these indexes are reduced (but the other traditional indexes such as ejection fraction are normal), it may signify a subtle decreased cardiac function especially in heart failure patients.

I know it may sound a bit confusing when discussing about these technical terms, but the most important part of the whole medical history is the fact you have no clinical symptomatology of heart failure. One important medical test to clearly investigate your cardio-pulmonary performance is cardiopulmonary exercise testing by measuring peak VO2.

You may discuss with your doctor on the above mentioned issues.

I remain at your disposal for any further questions.

Regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 4513 Questions

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What Do The Cardiac Ultrasound Results Indicate?

Brief Answer: My opinion as follows: Detailed Answer: Hello again, dear xxxxxx I would like to give some more explanations regarding your cardiac ultrasound findings as follows: Your left heart chambers seems to be within normal ranges as stated, so there is no left heart cardiomyopathy. Regarding your right heart chambers, as your right atrium and ventricle are within normal ranges and also right ventricle function is preserved a right heart cardiomyopathy is excluded. This conclusion is supported also by the fact pulmonary artery systolic pressure (PASP) is normal. So, in conclusion CTEPH (chronic tromboembolic pulmonary hypertension) is totally excluded. Your should relax and don#t worry about this issue. What is recommended in this regards is to avoid any favoring factor for circulating blood stasis and pro-coagulation factors. The most important is to control increased body weight and sedentary life-style. Avoid close smoking contacts. If you have a copy of your echo report, I would bee glad to directly review it here (you could upload it here). Hope to have been helpful to you! In case of any further questions, feel free to ask me again. Kind regards, Dr. Iliri