What Do These Following ECG And Cardiac Echo Reports Indicate?
Baseline echo demonstrated normal left and right tricuspid valve function with mild regurgitation. Moderate pulmonary hypertension.
ECG demonstrated significant ST depression mainly in inferior leads and v6 Strongly positive stress test
Stress test indicates inferior hypokinensis which correlates with the ECG changes . Hypertensive thru out stress test. I am 63 year old female with a history of asthma and have smoked for 40 years but no longer smoke. What is the prognosis of these findings, can it be cured or helped.
Prognosis is great in your case.(though angiography will make it more clear
Detailed Answer:
Hi,
Welcome to Health Care Magic, Thanks for writing to us,
I am Dr.Muhammad Ahmad, I have read your question,I am a licensed family physician and doing my level three research and training in Cardiology, I understand your concern and will try to help you in the best possible way.
You wrote your report in here I will hereby dissect it into pieces to explain to you what does it mean. Then i will come to your prognosis.
Baseline echo demonstrated normal left and right tricuspid valve function with mild regurgitation. Moderate pulmonary hypertension.>>It means you have smoked for years and you have asthma too so there is increased tension in lung capillaries which has put mild pressure on your heart valve. Not a big problem in function of heart though.
They stressed your heart which they would have done with Some med like dobutamin i suppose, we do it because heart might not show any signs or narrowed, blood supplying coronaries in normal circumstances but when it is stressed and it starts beating double or ripple the normal rate it's blood demand increases but tightened blood vessels can't supply enough and changes are shown in both Echo and Ecg this is a test done to fore see danger of a heart attack in future.
So when they stressed your heart, you ECG leads representing your right coronary artery showed changes . It means it is not an attack but your coronary was 50-60 % blocked so when blood demand increased that blocked artery couldn't coup up with increased demand.
Then they confirmed it with stress echo.. and area of right coronary supply was not contracting well at greater speed that's because it was not getting enough oxygen for contraction.
NEXT STEP:
Angiography will be done which will tell:
1) Is it blocked??.
2) Where is it blocked.
3) At how many places is it blocked?
4) In how many arteries the blockage is?
5) What is the extent of blockage?
Why do we need to know these things?
It will make us decide wether you just need medicine? or a Stent ? more than one stent ? or a Heart by pass.
PROGNOSIS: Your heart is no way damaged , mainly it will be decided on angiography but if it just stays till one or two stents prognosis is excellent , you can run a marathon after it and keep doing it for twenty years no worries.
If it comes to Bypass, it's a big surgery but again prognosis is superb.
So i would suggest you not to panic. Start your medication and see what your cardiologist has to say . Every thing should be fine.
I Hope this answers your question, if your have more queries feel free to ask, otherwise close the discussion and rate it. Wish you the best of health.
Regards,
Dr.Muhammad Ahmad.(Licensed Family Physician)
M.B.B.S.
Resident M.D Cardiology
just the normal stress test
and I failed after 4 mins
Stress can be induced in many ways.
Detailed Answer:
Hello thanks for writing back,
It's the same thing, doctors just have to get the heart running at a higher rate than usual weather it's done by drug, running or cycling it doesn't matter.
Just don't get much anxious every thing will hopefully be fine. You can share your reports and proceedings any time with me if you wanna discuss further.
My link is
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304
Stay blessed
Regards Dr .Muhammad Ahmad
Thank you for your helpful advice
But I have had the angiogram and all my vessels are normal, why am I so breathless?
Where do I go from here?
Can this just be reflux?
I have a bad problem with flatulence and swallowing the wrong way and so coughing
God bless
I welcome your reply
Kind regards XXXX
Great news it is
Detailed Answer:
Hello,
Thanks for writing back,
It's infact a great news that your heart is fine, who wants to have a heart disease? it's better without it.
1)Do you get shortness of breath while you lie down?
2)Since when you have breathing problems ? have they been getting worse with time?
3)Have you visited a pumonologist lately?
4) Did you ever get pulmonary function tests done?
Regards.
Dr.Muhammad Ahmad
My Dr changed my medication to Simbicort 400mcg and Bretaris inhalers
where to from here
I would appreciate your reply
XXXX
Things will get better with time
Detailed Answer:
Hi,
Thnaks for writing back, I hope you must be feeling calmer after you heart being ruled out as a cause of your problems with breathing.
If your heart had issues too then it would have been very difficult for you and the doctor to manage your shortness of breathe because lungs and hearts bouth would have contributed to the problem. Now as heart is not the cause and according to your last response to my questions , lungs seem to be the only cause of the problem,
you can focus on managing the lung problem without thinking of other causes of shortness of breath.
Your Pulmonary function tests showed that you had COAD and you are also taking medicine for this too, and this is now what you have to follow and make better now.
You asked me what should you do about your shortness of breath after this point so here it is.
1) Stay determined and positive abiut treating your COAD.
2) Use medicines regularly, rather religiously and also follow life style changes and precautionary measures told to you by your doctor.
3) Read about COAD and get yourself educated about the problem.
4) Protect yourself from the things which aggravate the problem like dust..allergens etc.
5) COAD means compromised lungs..which can be because of any reason but in your case smoking seems to be the culprit ,you may make those lungs better with medicines but may be they wont go back to 100% so define your limits, don't overwork yourself but at the same time try to make your stamina and functionality better at this given percentage of lung work.
6)If things start getting worse, immediately contact your doctor.
7) Pay regular follow up visits to your doctor and discuss possible measures you can take to make things better and the possible medicine change which can help you further.
Hopefully as the time passes things will get better and better for your.
Wish you the best of health and quick recovery,
Have a great and safe weekend.
Stay blessed.
Regards.
Dr.Muhammad .Ahmad