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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:
CMR would be required.
Detailed Answer:
Hello!
Welcome to - Ask a Doctor- service!
Considering your son's previous medical history, as a recent change in EF is supposed by cardiac ultrasound it would be necessary to undergo cardiac magnetic resonance imagine test (CMR).
CMR is considered a gold standard for noninvasive morphological cardiac evaluation, cardiac performance quantification, cardiac tissue characterization and importantly in this case for a precise review of vascular anatomy and pathology. This imagine test offers high resolution imagines, precise quantification and what is equally important doesn't pose the patient to any risks of radiation or other complications.
It would definitely clarify whether any cardiac abnormality is present and potential underlying causes.
You should discuss with his attending cardiologist on the opportunity of performing CMR.
Hope to have been helpful to you!
Kind regards,
Dr. Ilir Sharka
cardiologist
CMR would be required.
Detailed Answer:
Hello!
Welcome to - Ask a Doctor- service!
Considering your son's previous medical history, as a recent change in EF is supposed by cardiac ultrasound it would be necessary to undergo cardiac magnetic resonance imagine test (CMR).
CMR is considered a gold standard for noninvasive morphological cardiac evaluation, cardiac performance quantification, cardiac tissue characterization and importantly in this case for a precise review of vascular anatomy and pathology. This imagine test offers high resolution imagines, precise quantification and what is equally important doesn't pose the patient to any risks of radiation or other complications.
It would definitely clarify whether any cardiac abnormality is present and potential underlying causes.
You should discuss with his attending cardiologist on the opportunity of performing CMR.
Hope to have been helpful to you!
Kind regards,
Dr. Ilir Sharka
cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. llir,
My friend was saying to me maybe he has caught some type of virus and it's causing his EF to be lower now. Could this be and is there a way that we can see if this is possible with a blood test or something? I know that he is becoming more and more tired daily so I'm very concerned. I will immediately request that CMRI test tomorrow. Can this problem with EF be cured and if so, what's the options because at 50% he could be heading toward heart failure. Am I correct? I'm truly lost with what to do next but I know I don't want to take too much time because I don't want this to be fatal.
My friend was saying to me maybe he has caught some type of virus and it's causing his EF to be lower now. Could this be and is there a way that we can see if this is possible with a blood test or something? I know that he is becoming more and more tired daily so I'm very concerned. I will immediately request that CMRI test tomorrow. Can this problem with EF be cured and if so, what's the options because at 50% he could be heading toward heart failure. Am I correct? I'm truly lost with what to do next but I know I don't want to take too much time because I don't want this to be fatal.
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello again!
You are right! Viral infections sometimes may affect also the heart leading to inflammation of myocardium and/or pericardium, with subsequent cardiac dysfunction, arrhythmia and heart failure. Cardiac magnetic resonance through its techniques of tissue characterization, morphological and functional study may properly investigate, confirm or rule out inflammation (myocarditis, pericarditis) and the degree of cardiac dysfunction.
Besides the image test, laboratory tests (serological tests) may confirm a possible viral infection too.
You should discuss with the attending doctor on the above mentioned issues.
Let me know in case of any further questions.
Regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello again!
You are right! Viral infections sometimes may affect also the heart leading to inflammation of myocardium and/or pericardium, with subsequent cardiac dysfunction, arrhythmia and heart failure. Cardiac magnetic resonance through its techniques of tissue characterization, morphological and functional study may properly investigate, confirm or rule out inflammation (myocarditis, pericarditis) and the degree of cardiac dysfunction.
Besides the image test, laboratory tests (serological tests) may confirm a possible viral infection too.
You should discuss with the attending doctor on the above mentioned issues.
Let me know in case of any further questions.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Dr. lliri,
Thanks for that explanation. Last and final question, if he did have COVID and was not aware of it and it is what's causing the 50% now Ejection Fraction. Can anything be done now to restore the EF or will he just get heart failure? In other words is there anything that can be done?
If it's some other type of virus or bacteria what can be done to help him now or is there nothing? He has an appt tomorrow and I want to be prepared to ask them certain things so that way I will have your information and know exactly what to say.
Thanks you!
Thanks for that explanation. Last and final question, if he did have COVID and was not aware of it and it is what's causing the 50% now Ejection Fraction. Can anything be done now to restore the EF or will he just get heart failure? In other words is there anything that can be done?
If it's some other type of virus or bacteria what can be done to help him now or is there nothing? He has an appt tomorrow and I want to be prepared to ask them certain things so that way I will have your information and know exactly what to say.
Thanks you!
I'm waiting for a response. Please get back to me asap.... I've tried to upload the heart test results to you but the system will not let me upload them to you. Is there another email I can upload to.... Thanks
Brief Answer:
I would recommend as follows:
Detailed Answer:
Dear XXXXXXX
There is not too much to be done as the damage of the myocardial tissue may be a consequence of the virus.
Anyway, a cardiac MRI would help investigate ongoing inflammation or the presence of fibrosis and determine more exactly the EF.
I would also recommend taking carnitine and coenzyme Q10 supplements in order to help improve the myocardial performance.
Hope you will find this information helpful!
You should discuss with the doctor on the above test.
Wishing all the best,
Dr.Iliri
I would recommend as follows:
Detailed Answer:
Dear XXXXXXX
There is not too much to be done as the damage of the myocardial tissue may be a consequence of the virus.
Anyway, a cardiac MRI would help investigate ongoing inflammation or the presence of fibrosis and determine more exactly the EF.
I would also recommend taking carnitine and coenzyme Q10 supplements in order to help improve the myocardial performance.
Hope you will find this information helpful!
You should discuss with the doctor on the above test.
Wishing all the best,
Dr.Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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