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What Do The Following ECG And ECHO Test Results Indicate?

Posted on Thu, 30 Jun 2016

Question: Hi my father(age-61) undergoes ECG and ECHO test and following are the findings(He is Diabetic from 25 Years)
1.) ECG says Possible Inferior Myocardial Infarction (III,aVF)
Slow Progress of R V1-6
Slight ST Depression(V2,V5)
Marked ST Elevation (V6)
ECG report also mentioned UNCONFIRMED REPORT
2.) ECHO Report says :-
In doppler study MITRAL VALUE A>E
ECHOGENICITY is mentioned good
Concentric left Ventricular hypertrophy
Diastolic dysfunction of left Ventricle A>E
LEFT Ventricle :- Concentric left Ventricular hypertrophy . NO RMWA of LV
Rest everything is Normal.

What to infer from this report? Have my father experienced heart attack or is he prone to?Please tell truly?

Answered by Dr. Shuba hariprasad (2 hours later)

Brief Answer:
Reports Indicate that he's prone to heart disease.No evidence of heart atta

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

I've gone through the reports and your query.
The ECG is a study of the electrical activity of the heart and the Echo reflects the mechanical activity.

The ECG is abnormal indicating ischemia (reduced blood flow to the heart) which can happen if the arteries (blood vessels) that supply the heart have any blocks in them.

The Echo is normal indicating that the heart muscle has not been damaged yet. This is good, as precautions (medications, exercise, diet changes) can be taken to minimize Complications and chances of heart attacks in the future, which could result from the blocked arteries

Being a long term diabetic, he is prone to heart disease. This risk is increased if he is hypertensive, smokes, has high cholesterol or thyroid hormone imbalances

I recommend :
-an angiography to check for blocks in the heart vessels.
-a cardiologist opinion
- blood tests to check for anemia, cholesterol levels, Thyroid problems.

Based on the above he may be started on blood thinners, heart protective medications and lipid lowering agents.
If his blood glucose levels are not in tight control, he may a change of antidiabetic medications or dosage.
Lifestyle changes, diet, exercise will also be advised.

Hope I've answered your queries. Please let me know if there is anything else I can help you with.

Wish you all good health.
Regards,
Dr. Shuba Hariprasad

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Shuba hariprasad (21 minutes later)

Hi Mam,

Thanks for the quick answer. IN ECG it is mentioned Inferior Myocardial Infarction (III,aVF) which means heart attack.Can we be sure that no heart attack has happened till now.
Also you said ECHO is normal but in report following abnormalities are mentioned:-
Concentric left Ventricular hypertrophy
Diastolic dysfunction of left Ventricle A>E
LEFT Ventricle :- Concentric left Ventricular hypertrophy
You have also mentioned about artries but in ECHO it is mentioned Normal flow through Valve/No clot seen

Please consult what exactly is happening?

Answered by Dr. Shuba hariprasad (28 minutes later)

Brief Answer:
Echo does not indicate Infarction.

Detailed Answer:
Hello,
Thank you for the follow up.

Sorry that I wasn't very clear
Allow me to explain once more and be more clear.

The ECG is suggestive of ischemia (possibility). The changes are suggestive of compromise is blood flow to the heart.

The Echo, however does not show signs of ischemia (indicated by regional wall motion abnormality-RWMA). The affected part of the heart muscle will move differently compared to the unaffected part.
Concentric left ventricular hypertrophy is a common finding in that age, as is diastolic dysfunction especially in those with high blood pressure. This does not mean it is a heart attack

The valves mentioned in the Echo are those through which blood passes between the four chambers of the heart.
The blood vessels that supply the heart muscle (coronary arteries) cannot be assessed by an echo. An angiography study of these vessels has to be done.

To summarize,
Your father has a high risk of heart attack (being diabetic and with ECG changes). The good news is that this was detected before there was any significant damage to the heart muscle.
An angiography and cardiologist opinion is the next step.

Hope this helps. Please let me know if there is anything else I can help you with.

Regards,
Dr. Shuba Hariprasad

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Shuba hariprasad (9 minutes later)

Thank you mam for such a good description . Now i close this question with following understanding:-

There is no heart attack as of now by looking at reports of ECG and Echo.
Chances of heart attack are high in future
Should consult Cardiologist and go for angiography.

Also a final question! Mam as these are early findings which is a good thing, so are there proper medicines available to prevent heart attack or heart related issues in near future?

Answered by Dr. Shuba hariprasad (9 minutes later)

Brief Answer:
Yes, reduces risk but possibilities still present

Detailed Answer:
Hello,

Yes there is no definite evidence of heart attack at present.

Yes, there are measures that can be undertaken (medications and lifestyle changes) that can minimize risk of heart attack.
Please understand that while the risk can be reduced, it still exists and possibilities of heart attack will still be present.

Hope I've helped.
I would be happy to answer any further questions you may have.
Regards,
Dr. Shuba Hariprasad

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Naveen Kumar