What prognosis can be made from an ECHO report of someone with atrial fibrillation?
1. Left atrial volume index is moderately enlarged, 47.69 cm./m2.
2. Right ventricle enlarged 4.2 cm at base in apical right ventricular focused view. Global right ventricular systolic function appears mildly depressed.
3. Tricuspid annular plane systolic excursion (tapse) is 1.7 cm.
Estimated pulmonary artery pressure is 49 mmhg.
4. Mitral valve is mildly regurgitated.
5. Tricuspid valve is moderately regurgitated.
6. IVC enlarged and collapses < 50% with sniff, suggesting high right atrial pressure of 15 mmHg.
7. Eccentric hypertrophy
Also, she has history of afib. that comes and goes. She has been cardioverted, which usually helps for a few months and tried the ablation that did not work.
What can be done to improve these findings and prevent them from worsening? Echo done three years ago showed pa systolic pressure 31 mmhg and ivc was normal and with sniff was 3 mmHg. Also tricuspid valve was mildly regurgitating. So, it seems things have progressively gotten worse. Please help!
Optimization of medical therapy.
After going through the medical details provided by you of your mother I can very well understand your concern for her health and well being.
Considering the present status age is a big deciding factor here. As she has already crossed her 70's with a slow progressive worsening over a period of couple of years so aggressive management won't be possible in her case and optimization of medical therapy will be the best way here.
By optimization I mean slowly uptitrating the medicine dosage up to her tolerance under her treating cardiologist supervision.
The general precautions which should be taken are:
1. Timely and regular medicine intake.
2. Small healthy protein rich and frequent meals.
3. Limiting her water intake to 1 to 1.5 ltrs per day. (Very important).
4. Low salt diet.
5. No caffeine containing drinks at all.
I hope this information will guide you properly.
Also, what is prognosis for someone with these findings?
Answer few questions.
I would like to know..
1. Whether a coronary angiography was done anytime in the past?
2. Kindly upload the ECG and Echo report images.
3. Whether she is diabetic and hypertensive, any thyroid issues?
Kindly provide the required information.
Multiple comorbidities, so with 70+ age group the overall prognosis is not very good.
Without having the required information, it just become a vague guess to talk about the long term prognosis and all those things.
However, as she has multiple comorbidities like diabetes, hypertension as well as thyroid issues along with 70+ age group the overall prognosis is not very good.
Proper adjustment of the medicine dosage time to time will keep patients asymptomatic. So optimization Of medical therapy is needed time to time.
I hope I was helpful.
Dr. Bhanu Partap, Cardiologist
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