
My Sister Is 55 Years Old And She Has Congenital

Would you please assess the Echo specifically if indicative of something that needs attention?
I would explain as follows:
Detailed Answer:
Hello!
Welcome back on - Ask a Doctor - service!
I passed carefully through your sister's medical history and attached laboratory tests.
Regarding the above, I would explain that her liver and renal function tests seem perfect.
From the other side there are some changes in her cardiac ultrasound report (diastolic dysfunction) that could be explained with her longstanding hypertension.
What is suspicious, appears wall motion abnormalities (hypokinetic basal and mid posterior septum, basal and mid anterior wall); which requires further diagnostic workup to rule in/out ischemic heart disease.
For such purpose an exercise cardiac stress test or better a stress cardiac ultrasound would be necessary.
Anyway, even a hypertensive bout may be associated with transient wall motion abnormalities without the presence of coronary artery disease.
So, the tests are recommended to differentiate and conclude on the clinical significance of the echo findings.
You should discuss with her attending doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of any further questions, feel free to ask me again.
Kind regards,
Dr. Iliri


Opinion as follows:
Detailed Answer:
Hello again!
Coronary angioCT could be another alternative for investigating coronary artery disease, though it is performed by utilizing X ray radiation.
In case she has additional risk factors besides hypertension, it could be a rationale cardiac test too.
It also depends by the local expertise which test to choose first.
It could be decided by discussing with the attending doctor.
You could upload the test results here for a review and a second professional opinion after the tests are done.
Regards,
Dr. Iliri


As far as I learned the artries are in a good condition and now we do not have a clear reason for the hypokinetic basal and mid posterior septum!
Pls advise
I would explain:
Detailed Answer:
Hello again!
A further insight on the real picture of cardiac wall motion abnormalities and the potential causes would be obtained by a cardiac magnetic resonance imagine (CMR) test.
Focal fibrosis due to longstanding hypertension, previous myocarditis, etc. or kinetics abnormalities due to micro-vascular dysfunction, etc. could be some of the reasons easily detectable with CMR.
It is necessary to be performed in a center with a good level of expertise.
Kind regards,
Dr. Iliri

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