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Dr. Andrew Rynne

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What does my lab test report indicate?

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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 5916 Questions

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Posted on Wed, 15 Mar 2017 in General Health
Question: Dear Dr Sharka,

I hope you will be able to review my previous question about the diagnosis i had during my health check a comment in my report about Mitral valve prolapse. Which you had mentioned in your reply on 17th of XXXXXXX last time - I dont need to worry. Just for your informaiton, I am XXXXXXX and the above finding was during my regular health check in XXXXXXX I am a resident in Nigeria though and now i am back here.

I have been experiencing for the last few weeks some mild occasional sensation in the chest though i was able to do regular exercises without any discomfort.
Just to get another review done - I visited a Cardiologist (In Nigeria where i am located these days). They conducted Echo tests, Blood tests, ECG and the Tread mill test. The report is also attached. After thorough tests the cardiologist told me everything is absolutely normal. And advised me to take a medicine "GAVISCON" for heart-burn and gastro problems. I do have a long term issues of excessive gas formation and burping from many years. Surprisingly ever since i started taking the medicine the slight chest discomfort and sensation feeling i was experiencing earliar disappeared!

My questions therefore are:
(a) Is the normal that during health check up the echo test that was conducted could have been a wrong diagnosis. Normally the echo tests are done in a very rushed up manner in a matter of 2 mins compared to the 2nd one where they tested me almost for 30 mins.
(b) What is your opinion on the quality of diagnosis in the country where i am presenting residing (Nigeria). Is the condition of Mild Prolapse difficult to diagnose.
I did share the findings of the previous health check report with the Cardiologist and he re-assured that its absolutely normal. They even gave me the Video of the Echo test reports on a CD.
(c) The "gaviscon" syrup that i am taking currently. For how long can i continue to take it. Ever since i started consuming it my chest sensation has disappeared and so has burping and excessive gas.
(d) When i visit XXXXXXX again should i go back for a review in the same hospital. By the way it is a famous hospital chain in XXXXXXX (Apollo Hospitals) where even many Africans go for complex medical issues. It is very unlikely for anyone to expect that they would do a wrong diagnosis and in Nigeria a cardiologist would give a very different diagnosis. I am actually amused.

Regards,
XXXXX
doctor
Answered by Dr. Ilir Sharka 4 hours later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome back on HCM!

I carefully reviewed your recent uploaded medical reports and echo and here are my answers to your questions:

a- I agree with you that a prolonged and careful examination is more reliable compared to a fast performed echo. It is very likely that mitral valve prolapse can be missed when the examiner is not attentive, but from the other side it is not rare when mitral valve prolapse is overdiagnosed.

b- Regarding the diagnosis of mild mitral valve prolapse, you should know that it is not a difficult diagnosis to be concluded during a cardiac ultrasound exam wherever the echo lab is situated (Nigeria, Europe, USA, etc.). The only care requisit is a well trained and licensed examiner cardiologist. As you refer about the busy XXXXXXX Hospital and facing a very regular medical report from your last check up, it sounds that the conclusions of the cardiologist conclusions at your residence place sound more reliable. Also the echo reportseems to be more comprehensive (more complete). Anyway, you should know that there is not a significant difference between the presence or absence of mild prolapse, because it has not any clinical significance and does not have any impact on your quality of like or longevity.

c- Regarding "gaviscon" syrup, I would recommend taking it as a symptomatic relief when you have troubles. It help neutralize the increased gastric acidity. Another effective way to treat your symptoms (burping, excessive gas) is to reduce the production of the gastric acid by taking PPI (omeprazole, pantoprazole, etc.) or Zantac. All these drugs (including gaviscon syrup, can be used for a long time, every time that you have troubles).

d- It is difficult for me to give a prejudgement regarding a specific medical test report or institution.
I could say that a performance of a medical service relies on several parameters; among them as the most important would be the commitment to make accurate diagnosis and conclusions and this would surely require not only the appropriate medical technology but also medical staff engagement, enough time and team collaboration.

I would also recommend checking again fasting glucose and HbA1C levels to investigate for diabetes, as your uploaded fasting glucose value is high.

Besides your Total Cholesterol/HDL ratio is 6.3, which indicates dyslipidemia and an increased cardio-vascular risk related to your blood lipid profile. That is why I would recommend take more food reach in omega 3 fatty acids (fish, fish oil, olive oil, walnuts, etc.) and reduce saturated food (butter, red meat, etc.) and food containing sugar or sweats. Aerobics is also helpful in reducing LDL and increasing HDL levels, thus leading to a reduction of your cardio-vascular risk.

Hope to have clarified some of your uncertainties!

If you have any other questions, please don't hesitate to ask me again.

Wishing all the best,

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