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What Does This Echocardiogram Report Indicate?

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Posted on Mon, 5 Oct 2015
Question: I recently had an echo that showed my amplatzer was seated properly. My asd was closed three years ago. However the results also reported moderate mitral valve regurgitation and bi atrial enlargement. However BP and stress test were normal. I am quite active and cycle regularly. Is it likely I'll need a valve procedure?
doctor
Answered by Dr. Priyank Mody (17 minutes later)
Brief Answer:
No valve procedure in near future, do go through the detail answer :)

Detailed Answer:
Hello, I am Dr Mody and I will be addressing your concern.
Mam by three years, endothelisation of the device occurs and if there is no leak a cross the asd, I don't think we need to worry much about the asd forever in life.
Now considering that you u are 41, so asd closure was done when you were 38, considering asd is a congenital anomaly so it would have been present since birth. Now over the first 38 years this asd would cause some he Mody XXXXXXX change in your heart and hence the biaxial enlargement and moderate MR, so coming to your query
Presently you done need to do anything for the MR or bi atrial enlargement, you Do NOT require a valve procedure at present or in near future.
So what will we do?
Watch for symptoms. If you get breathlessness on exertion, some palipation, re evaluate the mitral regurgitation.
If no symptoms, routine evaluation with echo every 2 years is what I would suggest.
Also in most probability if you see the echo done during pre operatively before the asd closure, it would have some bi atrial enlargement and MR.
So if no symptoms, you can safely wait for your cardiologist to one back and then discuss the further plan, intermediate anything needed you may always drop me a msg.
I would be in a better position to help, if you can upload the last echo, and the operative note s,
Regards Dr Priyank Mody, XXXXXXX
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Priyank Mody (11 hours later)
Hi Dr Mody,

Pre asd closure my RH atria was enlarged and the MV reguritation was rated as 'trivial'. 12 months after the closure the RH atria was back to a "normal" size and no shunt. The MV regurg was not mentioned. So now three years later the MV regurg is called "moderate" and somehow both atria are enlarged......im confused. And concerned. I went back to my cardio for a check up as i had started getting dizzy and very tired just like i had before the asd was closed. So you understand my concern. The asd is apparently seating properly. So im worried that the MV may be causing my dizziness and fatigue. No shortness of breath as yet. I have enclosed a picture of the echo report. I look forward to your thoughts.

Thanks again,
XXXX XXXXXXX
doctor
Answered by Dr. Priyank Mody (20 hours later)
Brief Answer:
Be reassured, nothing urgent. Repeat echo if possible

Detailed Answer:
I would apologise for time delay as I wanted to answer in peace as it needed discussion.
Thanks for sending the report as it cleared a misunderstanding,
1)Now the mv (mitral) regurgitation is just Mild, so I don't forsee the symptoms because of that. It's not moderate so you are mistaken perhaps.
2) second the it written mild to moderate tricuspid regurgitation, however the pressure are not significant so again I have my reservations
3) generally when asd closure is done, the right side of heart is enlarged due to long term shunting of blood from left side to right side, so when the asd is closed many a times it takes time for the right atrium and right ventricle to regression back to normal and it may not be complete, but when you said it had come back to normal and now again it's enlarged , is something confusing.
4) even if left atrial enlargement is there it can be explained because of mitral regurgitation which is independent of asd, and seen in as many as 25% of patients with asd.
Lastly both atrial enlargement is just borderline dimensions as mentioned in the report, also the pulmonary pressure is not significant to cause symptoms.
I know the above would be confusing for you so I would enlisted my views
1) The most important reason which I have is the reason of your symptoms might be transient atrial arrhythmia, which is common in asd closure and with evidence of be atrial enlargement
2) mitral regurgitation is nit significant, no treatment needed for same and it alone will not cause symptoms
3) tricuspid regurgitation, may be moderate but again normal pulmonary pressure, doesn't make it clinically significant
4) do get a review echo from the same doctor who did it previously, also you may take the previous Cd for reference to your doctor. Do upload the previous echo for my reference if available, as exho is subjective and will change according to the doctor who did it small variations should not be considered significant
5) ecg when symptoms or 24 holter to detect any arrhythmia @dizzimess, fatigue explained by it , fet blood investigation called NT pro bnp, if higher than a small dose of diuretic, if normal forget about the echo and rpt echo after 6 months to see any progression.
6) rule out the bon cardiac cause like decreased hemoglobin, thyroid function, lungs being normal etc depending on the symptoms
Hoping I could help, I would be happy for any assistance or clarification as the subject needs more compressive evaluation and discussion,
Regards Dr Mody

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Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Priyank Mody

Cardiologist

Practicing since :2009

Answered : 918 Questions

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What Does This Echocardiogram Report Indicate?

Brief Answer: No valve procedure in near future, do go through the detail answer :) Detailed Answer: Hello, I am Dr Mody and I will be addressing your concern. Mam by three years, endothelisation of the device occurs and if there is no leak a cross the asd, I don't think we need to worry much about the asd forever in life. Now considering that you u are 41, so asd closure was done when you were 38, considering asd is a congenital anomaly so it would have been present since birth. Now over the first 38 years this asd would cause some he Mody XXXXXXX change in your heart and hence the biaxial enlargement and moderate MR, so coming to your query Presently you done need to do anything for the MR or bi atrial enlargement, you Do NOT require a valve procedure at present or in near future. So what will we do? Watch for symptoms. If you get breathlessness on exertion, some palipation, re evaluate the mitral regurgitation. If no symptoms, routine evaluation with echo every 2 years is what I would suggest. Also in most probability if you see the echo done during pre operatively before the asd closure, it would have some bi atrial enlargement and MR. So if no symptoms, you can safely wait for your cardiologist to one back and then discuss the further plan, intermediate anything needed you may always drop me a msg. I would be in a better position to help, if you can upload the last echo, and the operative note s, Regards Dr Priyank Mody, XXXXXXX