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    What does this transthoracic Doppler echocardiography report indicate?

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Posted on Thu, 2 Jun 2016 in Hypertension and Heart Disease
Question: I had a transthoracic color doppler ECHO done recently and it showed a minimal left to right shunt. I had a bubble test and no right to left shunt was seen. All other aspects of the ECHO were normal . I had an echo a year ago and no shunt was seen. Could this recent ECHO finding of a shunt be a false positive? My main symptoms are SOB, having to take deep breaths and tachycardia when going up stairs or inclines.
doctor
Answered by Dr. Benard Shehu 1 hour later
Brief Answer:
I'm waiting for the requested data to be uploaded.

Detailed Answer:
Hi and thank you for asking!
I read your query and understood your concerns.

Before giving you an accurate answer I would like to have a look at your heart echo reports in order to evaluate the differences between the examinations.

This will help to differentiate between false positive and underlying heart disease (which may haven't been detected one year ago and may be the cause of your symptoms).

Can you please upload heart echo reports?
I'm waiting for the requested data to be uploaded!
Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu 13 minutes later
I do not have the old echo report available for upload. I have it on paper but I don't have a scanner. This is the new one. I copied and pasted it. I compared the measurements from the last one and they are basically the same, just that the last one didn't say anything about a shunt.


Study Components: 2D Color Doppler Spectral
BP: 118 / 82 HR: 70 Rhythm: Sinus
Technical Quality:Good
MEASUREMENTS (Male / Female) Normal Values
2D ECHO
LV Diastolic Diameter PLA 4.2 cm 3.7 - 5.6 cm Aortic Root Diameter 2.8 cm 2.0 - 3.7 cm
LV Systolic Diameter PLAX 2.8 cm 2.0 - 4.0 cm LA Systolic Diameter LX 3.6 cm 1.9 - 4.0 cm
LV Fractional Shortening 33.3 % 28 - 46 % LV Diastolic Volume MOD B 84.0 cm³ 67 - 155 / 56 - 104 cm³
LVPW Diastolic Thickness 0.9 cm 0.6 - 1.1 cm LV Ejection Fraction MOD 63.1 % >= 55 %
IVS Diastolic Thickness 0.9 cm 0.6 - 1.1 cm LV Stroke Volume MOD BP 53.0 cm³
RV Internal Dimension 2.1 cm 0.7 - 2.6 cm
DOPPLER
AV Peak Velocity 1.3 m/s MV Deceleration Time 238.0 ms
AV Peak Gradient 7.0 mmHg LV E' Lateral Velocity 17.3 cm/s
Mitral E Point Velocity 0.8 m/s Mitral E to LV E' Lateral 4.8
Mitral A Point Velocity 0.6 m/s TR Peak Velocity 1.9 m/s
Mitral E to A Ratio 1.3 TR Peak Gradient 14.4 mmHg
INTERPRETATIONS
Left Ventricle Normal left ventricular size and wall thickness with preserved systolic function. Ejection fraction 63%. No
wall motion abnormalities. Normal diastolic filling pattern.
Right Ventricle Normal right ventricular size and systolic function.
Right Atrium Normal size right atrium.
Interatrial Septum Cannot rule out PFO with minimal left-to-right shunt by color Doppler.
Left Atrium Normal size left atrium.
Mitral Valve Structurally normal mitral valve with trace mitral regurgitation.
Aortic Valve Tricuspid aortic valve with no flow abnormality.
Tricuspid Valve Trace tricuspid regurgitation with normal right ventricular systolic pressure.
Pulmonic Valve Trace pulmonic regurgitation.
Pericardium No significant effusion.
Aorta Not well visualized.
Other Normal IVC size with normal respiratory collapse.
CONCLUSION
1. Normal left ventricular size with preserved systolic function. Ejection fraction 63%. No wall motion abnormalities. Normal
diastolic filling pattern.
2. Trace mitral regurgitation.
3. Tricuspid aortic valve with no flow abnormality.
4. Normal right ventricular systolic function. Trace tricuspid regurgitation with normal right ventricular systolic pressure.
5. Compared with April 16, 2015 study, there is no significant change.
Heart Failure Society guidelines recommend evaluation for advanced cardio-vascular device therapies in those patients with the
ejection fraction (EF) of 35% or less.

I had a stress test and all it showed was a flat blood pressure response. When I go up 2-3 flights of stairs my heart rate increases to 130+. It sounds kind of like a gallop and I can hear a murmur which is not audible at rest. I feel fine when I am lying down. My heart rate quickly comes down. I used to be very active and I am normal weight.
doctor
Answered by Dr. Benard Shehu 15 hours later
Brief Answer:
Following advice.

Detailed Answer:
Hi back,

After reviewing the echo data I would like to suggest doing a trans esophageal heart echo. This will help to exclude false positive cases and to properly evaluate the left to right shunt.

Hope this will be of help!
Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Benard Shehu

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Practicing since :2004

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