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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do my x-ray reports suggest?

HEALTH MAGIC
Dear Sir,
Thanks for being there.
I have query which is related to cardiology, pulmonary, radiological reports. Please advise me on my health and medical/health needs.
I am reproducing extracts of reports over the last decade.
I have earlier been advised stenting but have not taken such surgery.
I am 60 years of age now; male with height now of 164 cms.(a decade back, it was 170 cms), weight is 66.5 kgs.
I was working in a Gulf country in the years 1993 to 1996. During a period of extreme distress my BP had gone to 120/100. I had to take Atenolol 100 for about 6 months where after half the dose would suffice. After another 6 months, my BP was normal and could stop taking medicines.
On 12/1/2002-in Tanzania-diagnosis; Rt. sided lower lobar pneumonia; ESR was 86 mm/1st hour; WBC -8.8.
Pnuemonia is not known to happen in Tanzania.
The x ray report was as follows : Findings -There is radiopacity in the right paracardiac region that suggest inflammatory lesion. No evidence of pleural lesion is noted. The mediastinum is normal seen. The soft tissue is unremarkable. The cardiac shadow is normal in size and shape.
Conclusions : The findings correspond with right paracardiac pneumonia.
8/3/2003- in Mumbai- X ray chest PA: large bulla seen at the right upper zone. Left lung field normal; Hila are in normal position and density. Both cp angles are clear. No pleural pathology is seen. Hear and aorta are normal. Bony thorax and diaphragm are normal.
From 2006, I have been working in different places in India. I have very bad cough in which no cough comes out but the coughing makes my mind blank for seconds and the sight in my eyes comes back to normal after about half a minute.
On 21/5/2008, a x ray report showed/stated the impression as normal. Eosinophil was 10; WBC was 15.3; sugar was normal; BP – 170/100.
On 19/2/2010, I was diagonized with acute Dyspnoea and was sent to a hospital for immediate hospitalisation. I had been unable to breathe and was taken in an ambulance with oxygen. I was admitted to ICU but within a few hours I was sitting up in bed and breathing well.
My weight was 72 kgs.
I was subjected to various tests such as ECG, ECHO, x ray, blood tests.
The blood report was as follows : Hb-13.3; WBC-17200; Eosinophils- 1.
While sitting in bed the next morning, I was having muscles cramps in the stomach. I left the hospital against medical advise with the intention of going of another hospital. After staying at home for a few days, I sought medical advise in another hospital and was advised to take admission for check ups. I was checked by specialists of pulmonology, cardiology, medicine. My TPR was normal. I was discharged after 3 days. During the 3 days the reports were as follows :
Chest PA view – Infective changes noted in right lower zone. Paucity of vascular markings noted in right upper zone- likely to be bullous lesion. Coarse vascular marking noted in left lung field. Both costophrenic angles are clear. Cardio-thoracic ratio is within normal limits.
The blood gas analysis showed following out of range : Barometric pressure(BP) -752.0 mmHg; PO2- 89.8; O2 saturation-96.9. Sugar, lipid profile was within normal range.
The ECHO report was as follows :
LV cavity is dilated. There is mild concentric left ventricular hypertrophy. There is global hypokinesia of LV. Moderate systolic dysfunction, LV EF=35%. Grade -1 LV diastolic dysfunction present. LA size is at its upper limit of normal. All cardiac valves are normal in morphology. Mild mitral regurgitation and mild Tricuspid regurgitation noted with colour flow. Mild Pulmonary hypertension present(PA pressure 38 mm of Hg). Intact IAS/IVS. There is no intrachamber clot/vegetation. No pericardial effusion present.
The cardiologist and Pulmonologist prescribed me the following medicines: on waking up from sleep-Pan 40, Duova -2 puffs; after breakfast-Cardace 2.5, Carzec 3.125, Lacilactone 50- ½ tab; after lunch Ecospirin 75; evening Tonact , Ativan 1 mg.
On 26/3/2010, I underwent Coronary Angiography in another hospital. The clinical summary was :- CAG revealed- Double vessel disease ( Mid LCx- 85%, distal LCx-90% & Proximal RCA-80% for which patient was advised PTCA & stenting to RCA & LCx proximal lesion with POBA / provisional stenting to distal LCx.
I did not undergo any surgery but continued with the medicines.
On 21/12/2013, I went for check ups. The reports were as follows :
Chest PA view – Coarse vascular markings noted in both lower zones. Unfolding of aorta noted. Costophrenic angles are clear. Cardio-thoracic ratio is within limits. Both the domes of diaphragm are smooth and regular.
The LFT report was follows : Mild restriction. Moderate reversible obstruction.
The ECHO report was as follows :
Impression – Concentric LVH ; LV Diastolic dysfunction(+); Trivial MR noted. The details are as follows – Lt. Ventricular concentric hypertrophy. No RWMA. Good LV systolic function, LV EF= 64%. Doppler evidence of LV diastolic dysfunction. Trivial mitral regurgitation is noted with colour flow. Other cardiac valves are morphologically normal and their motion also normal. Other cardiac chambers(LA/RA/RV)appear normal in size, thickness, motion. No evidence of pulmonary arterial hypertension. Intact IAS/IVS. There is no intrachamber clot/mass/ vegetation. No pericardial effusion seen.
The medicines prescribed to me by the cardiologist and a Pulmonologist are: Duova and Asthalin for SOS; Carzec 3.125, Rantac 150, Ecospirin Gold, Creser 40 , Ativan 2 mg. I had complained of rectal bleeding at times for which presumably Rantac was prescribed and Ecospirin Gold was changed to. For the bleeding, a specialist in Medicine prescribed me Zentel 400, Daflon, Duphalac. The bleeding had discontinued and I am presently taking medicines prescribed by the Cardiologist and Pulmonologist. I have not taken Asthalin till now nor Foracort prescribed for SOS in the year 2010.
I do not wish to go for surgery and I have a feeling that I have done quite well with a balanced diet, reducing fluids, eating ‘roti’/wheat instead of rice, green vegetables, salad,and vegetarian diet.
Please advise my health condition and whether I am on the right course. Do I need to have any further restrictions, changes in my lifestyle?
Please also advise whether my illness may be due to environmental pollution, wastes in the atmosphere.
Thanks & regards
Smarajit Mitra
Tue, 12 Aug 2014
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Internal Medicine Specialist 's  Response
I had gone through your query and understood your concerns.
As per your angiogram reports you have to undergo stent as per doctor said was right.there is minimal risk in stunting if done by an experienced cardiologist .I suggest you to go ahead with it for healthy living
Other medication are all perfect


Hope this guides you. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
If you do not have any clarifications, you can please close the discussion . Thank you.
Wishing you good health
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What do my x-ray reports suggest?

I had gone through your query and understood your concerns. As per your angiogram reports you have to undergo stent as per doctor said was right.there is minimal risk in stunting if done by an experienced cardiologist .I suggest you to go ahead with it for healthy living Other medication are all perfect Hope this guides you. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you do not have any clarifications, you can please close the discussion . Thank you. Wishing you good health