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What Do These CT Scan Results Indicate?
Question: I just had a CT Heart Coronary Arteries Angio w IV Contrast, and I received the results today. I am pleased that it showed normal coronary arteries and no coronary artery calcium; however, I am extremely concerned that it showed an additional finding which stated: Apical hyper trabeculation is noted. This sounds very dangerous to me. Please advise.
Brief Answer:
High probability of misdiagnosis
Detailed Answer:
Hello, sir. Thank you for your question and welcome to HCM. I have carefully seen your reports and understand your concern.
Hypertrabeculation or myocardial non-compaction is a rare and relatively new diagnoses. It results from a congenital defect that results in non-compaction of the heart muscle, which is a spongy matter during embrionic life. Most of cases are diagnosed in childhood or early adulthood and act like most of the cardiomyopathies, presenting with shortness of breath, easy fatiguability and swelling of the ankles. Why am I saying there is a low probability that this is your case? Well, one study showed that maximum of age that these patient achieve is somewhere between 39-44 years old, with a death from severe cardiomyopathy and/or life-threatening arrhythmias. The gold standard examination to reveal this problem is echocardiogram. Computed tomography (CT) scan may enhance the normal trabeculations of the heart muscle, which can reach up to 1.8 mm. Therefore, if you did not have the upper mentioned symptoms and, as your echocardiogram describes, these trabeculations are not depicted there, add the factor of your age pf 50 years old, makes this diagnosis less likely, but not impossible, however. At this point, I would recommend another carefully performed echocardiogram, to carefully depict this problem, if it is there, and/or a cardiac magnetic resonance imaging (MRI) or a positron-emeting tomography (PET) scan of the heart.
I hope I was helpful and thorough with my answer. I am happy to help, if you have further questions. Please rate my answer, if you do not.
Best regards,
Dr. Meriton
High probability of misdiagnosis
Detailed Answer:
Hello, sir. Thank you for your question and welcome to HCM. I have carefully seen your reports and understand your concern.
Hypertrabeculation or myocardial non-compaction is a rare and relatively new diagnoses. It results from a congenital defect that results in non-compaction of the heart muscle, which is a spongy matter during embrionic life. Most of cases are diagnosed in childhood or early adulthood and act like most of the cardiomyopathies, presenting with shortness of breath, easy fatiguability and swelling of the ankles. Why am I saying there is a low probability that this is your case? Well, one study showed that maximum of age that these patient achieve is somewhere between 39-44 years old, with a death from severe cardiomyopathy and/or life-threatening arrhythmias. The gold standard examination to reveal this problem is echocardiogram. Computed tomography (CT) scan may enhance the normal trabeculations of the heart muscle, which can reach up to 1.8 mm. Therefore, if you did not have the upper mentioned symptoms and, as your echocardiogram describes, these trabeculations are not depicted there, add the factor of your age pf 50 years old, makes this diagnosis less likely, but not impossible, however. At this point, I would recommend another carefully performed echocardiogram, to carefully depict this problem, if it is there, and/or a cardiac magnetic resonance imaging (MRI) or a positron-emeting tomography (PET) scan of the heart.
I hope I was helpful and thorough with my answer. I am happy to help, if you have further questions. Please rate my answer, if you do not.
Best regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Raju A.T
I had an ablation performed for SVT in Feb. could this have caused this issue? Also, does this also mean I have no blockages in my arteries?
Also If I do have this problem, how is it treated?
Also If I do have this problem, how is it treated?
Brief Answer:
Welcome back
Detailed Answer:
Hello again.
It is a congenital disorder, resulting (for unknown genetic reasons until now, as I said the first case was described on 2005) in non-compaction of the myocardium in the embryonic life. My opinion is that the ablation did not cause this problem.
It is treated as all other cardiomyopathies, with a combination of a beta-blocker, angiontensinogen converting enzyme inhibitor (ACE-I) and diuretics. I would strongly recommend you not to worry, until the next echocardiogram is performed, as this could be a misdiagnosis. As I said, yes it is a dangerous diagnosis, but combining your age, lack of symptoms and one normal echocardiogram, the probability is low.
I hope this helps.
Best regards,
Dr. Meriton
Welcome back
Detailed Answer:
Hello again.
It is a congenital disorder, resulting (for unknown genetic reasons until now, as I said the first case was described on 2005) in non-compaction of the myocardium in the embryonic life. My opinion is that the ablation did not cause this problem.
It is treated as all other cardiomyopathies, with a combination of a beta-blocker, angiontensinogen converting enzyme inhibitor (ACE-I) and diuretics. I would strongly recommend you not to worry, until the next echocardiogram is performed, as this could be a misdiagnosis. As I said, yes it is a dangerous diagnosis, but combining your age, lack of symptoms and one normal echocardiogram, the probability is low.
I hope this helps.
Best regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Raju A.T
Well I do get short of breath and fatigued and have incidences of heart palpitations which is why these tests were ordered. I also have a strong family history of coronary artery disease which it appears from this test that I do not have.
Brief Answer:
Hi again.
Detailed Answer:
Hello again.
I certainly hope I am right, sir, and this is not your case. As I mentioned, I know of one study, which concluded that these patients do not survive after the age of 39-44. Being a newly discovered diagnosis, as it is, I do not think more information is available. My opinion remains that another careful echocardiogram, baring in mind that CT suggested hypertrabeculation of the apex, should be performed. If the CT scan showed that you have a normal coronary tree, then it is true, since this test has a high negative predictive value.
Hope this helps. Please rate my answer, if you do not have follow-up questions.
Kind regards,
Dr. Meriton
Hi again.
Detailed Answer:
Hello again.
I certainly hope I am right, sir, and this is not your case. As I mentioned, I know of one study, which concluded that these patients do not survive after the age of 39-44. Being a newly discovered diagnosis, as it is, I do not think more information is available. My opinion remains that another careful echocardiogram, baring in mind that CT suggested hypertrabeculation of the apex, should be performed. If the CT scan showed that you have a normal coronary tree, then it is true, since this test has a high negative predictive value.
Hope this helps. Please rate my answer, if you do not have follow-up questions.
Kind regards,
Dr. Meriton
Above answer was peer-reviewed by :
Dr. Raju A.T
I am correct in saying that I do not have any signs of coronary artery disease, correct?
Brief Answer:
Yes
Detailed Answer:
Hi again!
Yes. If CT scan showed no cornary artery disease and no calcifications, then it is so.
Regards.
Yes
Detailed Answer:
Hi again!
Yes. If CT scan showed no cornary artery disease and no calcifications, then it is so.
Regards.
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Above answer was peer-reviewed by :
Dr. Raju A.T
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