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MY 20 YEAR OLD SON WAS BORN WITH A DOUBLE
Question: MY 20 YEAR OLD SON WAS BORN WITH A DOUBLE AORTIC ARCH AT 26 WEEKS GESTATION AND HAD IT REPAIRED 1 MONTH AFTER BIRTH. HE HAD CONTINUED CARDIIOLOGIST CARE VISITS UP TO THE AGE OF 18 WHICH WAS IN XXXXXXX OF 2017. AT THAT TIME HE RECEIVED A CLEAR XXXXXXX OF HEALTH. AT THAT TIME HIS LVIDs 3.0 was EF: 69% but NOW TODAY FEBRUARY 2021 AT 21 YEARS OF AGE HE WENT AND HAD AN ECHOCARDIOGRAM DONE AND NOW HIS EF: 50% AND WE CANNOT FIGURE OUT WHAT COULD HAVE CAUSED HIS EJECTION FRACTION TO DECREASE FROM 69% TO 50%.
WE ARE VERY CONCERNED ABOUT THESE FINDING AND WHAT TO DO NEXT? HE DOES NOT HAVE HIGH BLOOD PRESSURE AND THE DOCTOR SAYS HIS HEART LOOKS GOOD AND HIS LUNGS ARE CLEAR ETC.
WHAT DOES ALL THIS MEAN? WHAT CAN WE DO MEDICALLY TO FIND OUT THE NEXT BEST APPROACH FOR HIM? I'M SO CONCERNED ABOUT HIM HAVING HEART FAILURE OR HEART ATTACK. DO I HAVE VALID CONCERNS AND WHAT OTHER TYPE OF SPECIALIST SHOULD HE BE SEEING AT THIS POINT?
THANKS
WE ARE VERY CONCERNED ABOUT THESE FINDING AND WHAT TO DO NEXT? HE DOES NOT HAVE HIGH BLOOD PRESSURE AND THE DOCTOR SAYS HIS HEART LOOKS GOOD AND HIS LUNGS ARE CLEAR ETC.
WHAT DOES ALL THIS MEAN? WHAT CAN WE DO MEDICALLY TO FIND OUT THE NEXT BEST APPROACH FOR HIM? I'M SO CONCERNED ABOUT HIM HAVING HEART FAILURE OR HEART ATTACK. DO I HAVE VALID CONCERNS AND WHAT OTHER TYPE OF SPECIALIST SHOULD HE BE SEEING AT THIS POINT?
THANKS
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome to - Ask a Doctor - service!
I passed carefully through your son's medical history and would like to explain that to get on reasonable conclusions on his clinical conditions it would be necessary to review the examinations reports at the time his operation and the surgical technique itself.
A review of the exact pattern of the double aortic arch and potential associated abnormalities should be done.
In addition it would be helpful to review his last cardiac ultrasound report; if it is possible to upload it here for a direct review?
A very helpful and precise examination to fully answer all the above uncertainties and questions is cardiac magnetic resonance imagine test. By applying high resolution sequences in addition to contrast enhanced techniques it would be possible to fully and precisely clarify what is the exact ejection fraction (cardiac ultrasound may provide inter-observer and intra-observer variability even in the same patient), any underlying cardiomyopathy, valvular dysfunction, myocardial fibrosis, etc.). So, this would be my recommendation as the next diagnostic and follow up step.
Let me know in case you could provide me with additional medical information regarding the above mentioned issues.
I remain at your disposal for any further discussions.
Kind regards,
Dr. Ilir Sharka
cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome to - Ask a Doctor - service!
I passed carefully through your son's medical history and would like to explain that to get on reasonable conclusions on his clinical conditions it would be necessary to review the examinations reports at the time his operation and the surgical technique itself.
A review of the exact pattern of the double aortic arch and potential associated abnormalities should be done.
In addition it would be helpful to review his last cardiac ultrasound report; if it is possible to upload it here for a direct review?
A very helpful and precise examination to fully answer all the above uncertainties and questions is cardiac magnetic resonance imagine test. By applying high resolution sequences in addition to contrast enhanced techniques it would be possible to fully and precisely clarify what is the exact ejection fraction (cardiac ultrasound may provide inter-observer and intra-observer variability even in the same patient), any underlying cardiomyopathy, valvular dysfunction, myocardial fibrosis, etc.). So, this would be my recommendation as the next diagnostic and follow up step.
Let me know in case you could provide me with additional medical information regarding the above mentioned issues.
I remain at your disposal for any further discussions.
Kind regards,
Dr. Ilir Sharka
cardiologist
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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