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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What do these ECG, 2d Echo and x-ray reports indicate?

Answered by
Dr.
Dr. Priyank Mody

Cardiologist

Practicing since :2009

Answered : 910 Questions

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Posted on Wed, 24 Aug 2016 in Hypertension and Heart Disease
Question: Dear Dr.
My Dad XXXXXXX Dubash aged 65 yrs just underwent Hernia repair. On admission before surgery we were told to do a few test among which ECG showed Bradycardia and in 2D Echo, the doctor who conducted the 2D Echocardiography said that "Heart is fine but there is a leakage in the valve". I have attached reports of ECG, 2D Echo, and Xray for your reference. Please advise as to what does the 2D Echo report say. What next is to be done and is it serious.
doctor
Answered by Dr. Priyank Mody 4 hours later
Brief Answer:
Nothing serious , it may be due to normal age related Degernation

Detailed Answer:
Hello XXXX,
I am Dr. Mody and I would be addressing your concern.
I went through all the reports you have attached .
I would enlist my observations as
1) The Ecg, echo and X ray chest are grossly normal and no further investigation is needed at present .
It would have been safe for performing hernia repair and let him recover well .
2) Sinus bradycardia in Ecg may be physiological at his age if particularly he is active and athletic.
3) Coming to echocardiography .
He has leak in one of the valves , this is not significant as noted by the doctor ( Grade 1 / 2)
So per say this not not require any further investigation if he has no symptoms and a routine echocardiography every 2 years to look for any progression.
The most probable reason of the leak may be normal age related degeneration of the valve .
Generally this leak progresses very slowly over the period of 10 - 15 years to be significant. Even then the heart is healthy can tolerate it well .
If he is hypertensive we can consider some medication which can help slow progression of the same .

However I would reassure you that the leak is nothing significant particularly with the echo a and X ray ( rules out dilated aortic root ) finding you have attached .
Let me know if any clarification is needed .

Regards Dr. Priyank Mody

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Priyank Mody 8 hours later
Dear Doctor,
First of all Thank you very much.
I'm very much relieved now. I also forget to mentioned that my father XXXXXXX Dubash didn't have nay complaint of chest pain or breathlessness in the past and right now also. He also went Hernia surgery and is much better now. Actually his younger son (my brother) expired 2 yrs back and that's why he is little disturbed. Now my main concern is "DO WE HAVE TO SEE A CARDIOLOGIST". My dad is also at times having heaviness and little breathlessness in the chest especially when he exerts too much. Which tablet do you recommend. Should we show him to a Gen Physician or a Cardiologist.
Please advise.

Regards,
XXXXX
doctor
Answered by Dr. Priyank Mody 17 hours later
Brief Answer:
A treadmill Stress test once he has recovered from the Surgery

Detailed Answer:
Hello ,
Hello as soon as your father recovers from hernia surgery and if he is active , I would suggest that you may consider getting a treadmill stress test done . This will check his exercise tolerance and if that is normal , he wouldn't have any significant cardiac disease . Also this would check the went to which his leak affects his exercise tolerance .The medication needed is life long and suggesting it on this forum is not justified as I haven't clinically seen your father or examined him last. .You may consider seeing a cardiologist for once .
Dr. Ajit XXXXXXX in Breach Candy is one of the finest I know and is like my teacher .
Regards Dr. Priyank Mody
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Priyank Mody 42 hours later
Hello,
Good evening Doctor,
My mother who is 65 yrs old has got low BP & is 40 kgs. When she was suffreing from fever severe cold & cough, she had a fall thrice with black out & doctor measured BP being 60 which was very low & the other doctor said that it might be a case of missing heart beat for a fraction of second wherein this black out happens & gave flatunta tablet for 2 weeks & one multi vitamin Enerjosh tablet. After five days of medicine & routine check up the doctor said that it was ok & continue the medicine.
Please advise
Thanks & Regards
doctor
Answered by Dr. Priyank Mody 23 hours later
Brief Answer:
A 24 hour holter Monitoring is the way forward

Detailed Answer:
Hello ,

The blood pressure you have mentioned can surely cause blackout life symptom as the perfusion to the brain is decreased transiently but per say it does not cause pause in pulse , rather pulse in such condition is higher as compensatory mechanism.

And if there is documented evidence by your doctor where he could feel the pause in pulse , I would suggest to get a 24 hour holder monitoring done which would record ex for 24 hours to detect any change in rhythm of the heart beats .

Regards Dr. Priyank Mody
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Priyank Mody 44 minutes later
Hello Doctor,
Thank you very much for your response.
Is a ECG required, will it reflect this thing. Pls advise.
Doctor had checked heart beat & said that it might be a case of missing heart beat.
Thanks & Regards
doctor
Answered by Dr. Priyank Mody 22 hours later
Brief Answer:
A ecg is basic investigation to check for missed beat

Detailed Answer:
Hello ,

ECG is the basic investigation to Rule out any rhythm disturbance and should be done whenever she goes for any check up .

However many a times when the missing heart best or pause is intermittent you may not get it in ECG so for a more comprehensive workup if there is a strong clinical possible 24 hour holder should be considered. A simple medication can treat the same if we know what variety of missed beat it is.
Also many missed beats may not require any treatment

Regards
Dr. Priyank Mody
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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