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What Does This Ultrasound Report Indicate?
Question: I recently had an echo-cardiogram and ultrasound of my carotid arteries. The radiologist noted the following: "There is significant peak systolic ICA velocity or velocity ratio elevation with bilateral antegrade vertebral flow". The PA that I saw at my doctor's office never mentioned this (I only saw it after I received a copy of the report for my records) and it would seem to be potentially relevant to the symptoms I'm experiencing. Can this finding be explained as well as possible causes (especially since there was only minimal thickening w/out plaquing?
The entire finding is as follows: Color duplex Doppler ultrasound evaluation of the bilateral carotid and vertebral arteries demonstrates minimal intimal thickening without significant plaquing. There is significant peak systolic ICA velocity or velocity ratio elevation with bilateral antegrade vertebral flow. Other test results: 24 hour Holter - normal Echo - Mild regurgitation but otherwise normal MRI brain - Negative MRI C-Spine - Mild spondylosis
The entire finding is as follows: Color duplex Doppler ultrasound evaluation of the bilateral carotid and vertebral arteries demonstrates minimal intimal thickening without significant plaquing. There is significant peak systolic ICA velocity or velocity ratio elevation with bilateral antegrade vertebral flow. Other test results: 24 hour Holter - normal Echo - Mild regurgitation but otherwise normal MRI brain - Negative MRI C-Spine - Mild spondylosis
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, after reviewing your Doppler ultrasound report, I would conclude that it does not indicate any serious medical condition.
The significant systolic ICA velocity or velocitz ratio elevation does not indicate any significant narrowing of the arteries, when no plaque is present. There is minimal intimal thickening, but without plaquing, which means that your carotid arteries are not narrow and have a normal blood flow.
The bilateral anterograde vertebral flow is part of every normal Doppler ultrasound.
So, to conclude, as your Doppler ultrasound, cardiac echo and Holter have resulted normal, there is nothing to be concerned of. You are not at any increased risk for stroke.
The mild regurgitation in your cardiac echo has not any clinical significance.
I would recommend continue on a healthy lifestyle:
- a healthy diet (Mediterranean diet would be recommendable)
- perform a lot of physical activity (yoga, aerobics, recreational sports, etc.)
- lose some pounds if you are overweight.
Hope to have been helpful!
Feel free to ask me again if you have any other uncertainties!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
Regarding your concern, after reviewing your Doppler ultrasound report, I would conclude that it does not indicate any serious medical condition.
The significant systolic ICA velocity or velocitz ratio elevation does not indicate any significant narrowing of the arteries, when no plaque is present. There is minimal intimal thickening, but without plaquing, which means that your carotid arteries are not narrow and have a normal blood flow.
The bilateral anterograde vertebral flow is part of every normal Doppler ultrasound.
So, to conclude, as your Doppler ultrasound, cardiac echo and Holter have resulted normal, there is nothing to be concerned of. You are not at any increased risk for stroke.
The mild regurgitation in your cardiac echo has not any clinical significance.
I would recommend continue on a healthy lifestyle:
- a healthy diet (Mediterranean diet would be recommendable)
- perform a lot of physical activity (yoga, aerobics, recreational sports, etc.)
- lose some pounds if you are overweight.
Hope to have been helpful!
Feel free to ask me again if you have any other uncertainties!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your quick reply Iliri, I do have a couple of follow up questions. Although the findings as you have described them do not put me at any additional risk of stroke (great news), is it possible that the increased/elevated PSV is related to the symptoms I describe below? What could cause this type of finding (increased/elevated ICA PSV) in an otherwise healthy person?
Symptoms:
"Pulsing" sensation in the back of my neck and back of my head (varies in intensity from barely noticeable to enough to move my head slightly (like a strong heartbeat but seems to at times be "off rhythm" from my pulse - difficult to explain). Occasionally feel some "pulsing" in both arms, but mostly the right. Occasional mild lightheaded feelings (not enough to cause loss of balance or consciousness). I've had an MRI of the brain (negative) and C-spine (mild spondylosis).
Thanks again.
Symptoms:
"Pulsing" sensation in the back of my neck and back of my head (varies in intensity from barely noticeable to enough to move my head slightly (like a strong heartbeat but seems to at times be "off rhythm" from my pulse - difficult to explain). Occasionally feel some "pulsing" in both arms, but mostly the right. Occasional mild lightheaded feelings (not enough to cause loss of balance or consciousness). I've had an MRI of the brain (negative) and C-spine (mild spondylosis).
Thanks again.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Thank you for the additional information!
I do not think that your symptoms are explained by these Doppler findings.
Have you checked your blood pressure values?
High blood pressure can lead to this symptomatology.
I would also recommend checking your thyroid hormone levels. A thyroid dysfunction can mimic this clinical scenario.
It is also necessary to closely monitor your blood pressure (in sitting position after 10 minutes of total relax) frequently during the day in order to exclude possible high blood pressure.
The cervical spondylosis could be responsible for the pulsating feeling in the neck and the dizziness. But this does not indicate a serious medical disorder. Correcting your posture and performing a lot of physical activity to reinforce the muscles of this region would help improve your situation.
As your brain MRI has resulted normal, possible vessel malformation or low brain perfusion or inflammation have been excluded.
So, definitely nothing concerning is going on with you!
Hope you will find this answer helpful!
If you have any other questions, please don't hesitate to ask me again!
Wishing good health,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Thank you for the additional information!
I do not think that your symptoms are explained by these Doppler findings.
Have you checked your blood pressure values?
High blood pressure can lead to this symptomatology.
I would also recommend checking your thyroid hormone levels. A thyroid dysfunction can mimic this clinical scenario.
It is also necessary to closely monitor your blood pressure (in sitting position after 10 minutes of total relax) frequently during the day in order to exclude possible high blood pressure.
The cervical spondylosis could be responsible for the pulsating feeling in the neck and the dizziness. But this does not indicate a serious medical disorder. Correcting your posture and performing a lot of physical activity to reinforce the muscles of this region would help improve your situation.
As your brain MRI has resulted normal, possible vessel malformation or low brain perfusion or inflammation have been excluded.
So, definitely nothing concerning is going on with you!
Hope you will find this answer helpful!
If you have any other questions, please don't hesitate to ask me again!
Wishing good health,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks again Dr. Iliri. My blood pressure is good (range from 100/70 - 125/85) but seems to be high whenever I'm in a doctor's office (I was told this happens to some people). I monitor daily with an Omron wrist cuff device.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
The rise in your blood pressure at the doctor's office is also called White Coat syndrome.
It is related to the anxiety and fear when consulting with the doctor.
But there is no need for any therapy, because it does not increase your cardio-vascular risk.
Your mean blood pressure values seem to be OK! So there is nothing to worry about.
Nevertheless, I would recommend checking your thyroid hormone levels to exclude thyroid dysfunction as a possible cause of your troubles.
Hope to have been helpful!
Best wishes,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello again!
The rise in your blood pressure at the doctor's office is also called White Coat syndrome.
It is related to the anxiety and fear when consulting with the doctor.
But there is no need for any therapy, because it does not increase your cardio-vascular risk.
Your mean blood pressure values seem to be OK! So there is nothing to worry about.
Nevertheless, I would recommend checking your thyroid hormone levels to exclude thyroid dysfunction as a possible cause of your troubles.
Hope to have been helpful!
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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