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What Does A Density On Echo Cardiogram Indicate?
Question: I was just told that there was a density (shadow) on my echocardiogram. The shadow is in the inferior vena cava. I am 65, take no meds, slender, normal blood pressure and don't smoke or drink. I also have No metabolic syndrome. I understand from reading articles on the Internet that this shadow could be a clot or a tumor. Are there any other possibilities? What is so confusing is that I did a 45 minute high impact aerobic routine (all jumping) the night before the echo with no problem---it is same workout I have been doing for 20 years. I lift weights too and feel great. I will see a cardiologist tomorrow but at least for tonight can you offer explanations for a shadow in the IVC and also give an explanation for my ability to do a killer aerobic workout. ( P.S. No swelling in ankles or legs either)
Brief Answer:
Other examinations are needed to confirm or exclude the diagnosis...
Detailed Answer:
Hi XXXX!
I read your query and understood your concerns.
An ultrasound shadow in IVC is an echo graphic finding that should be taken in consideration. It's may be due to thrombosis (clots in IVC) or tumors in IVC.
However you should keep in mind that this isn't a disease. This is only an echo graphic finding. It may be an artifact and this may explain your ability to do aerobic workout. You should do other examinations to confirm or exclude it.
If you were my patient I would have suggested doing the following examinations:
- Cardiac ECHO (both trans-thoracic and trans-esophageal ECHO)
- Chest X ray
- Angio CT for lungs and IVC.
Hope you will find this information helpful.
Wish you health!
Dr. Benard
Other examinations are needed to confirm or exclude the diagnosis...
Detailed Answer:
Hi XXXX!
I read your query and understood your concerns.
An ultrasound shadow in IVC is an echo graphic finding that should be taken in consideration. It's may be due to thrombosis (clots in IVC) or tumors in IVC.
However you should keep in mind that this isn't a disease. This is only an echo graphic finding. It may be an artifact and this may explain your ability to do aerobic workout. You should do other examinations to confirm or exclude it.
If you were my patient I would have suggested doing the following examinations:
- Cardiac ECHO (both trans-thoracic and trans-esophageal ECHO)
- Chest X ray
- Angio CT for lungs and IVC.
Hope you will find this information helpful.
Wish you health!
Dr. Benard
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
In your second paragraph you state the following:
"This is only an echo graphic finding. It may be an artifact and this may explain your ability to do aerobics."
Can you please fully explain what you mean by artifact? I would really appreciate a complete ip understanding of the word in this context.
Why a CT of the lungs? What are you looking for with an "angio"? Why a chest X-ray AND a ct of the lungs? How are they different?
"This is only an echo graphic finding. It may be an artifact and this may explain your ability to do aerobics."
Can you please fully explain what you mean by artifact? I would really appreciate a complete ip understanding of the word in this context.
Why a CT of the lungs? What are you looking for with an "angio"? Why a chest X-ray AND a ct of the lungs? How are they different?
Brief Answer:
Cardiac ECHO, CT and angio CT will help to find the cause of the shadow...
Detailed Answer:
Hi back,
Let me explain you further. The ultrasound beam pass threw muscle, ribs, bone and soft tissue. What we see on Echo are a scanning plan of all this structures and in some cases different structures (for example ribs) interfere with each other and this is how a shadow "Artifact" is produced. Sometimes we find only an Echo graphic shadow and other examinations are normal. In this case this is only an abnormal echo graphic finding.
This is why I recommended other examinations especially heart ECHO, CT and Angio CT. Angio Ct is a ct scan made with i.v contrast to better visualize blood vessels and this will help to exclude thrombus in IVC or in other veins (including pulmonary embolism). Also angio Ct will exclude any tumor or malignant disease.
Chest X ray is part of routine examinations before CT scans.
Wish you all the best!
Dr. Benard
Cardiac ECHO, CT and angio CT will help to find the cause of the shadow...
Detailed Answer:
Hi back,
Let me explain you further. The ultrasound beam pass threw muscle, ribs, bone and soft tissue. What we see on Echo are a scanning plan of all this structures and in some cases different structures (for example ribs) interfere with each other and this is how a shadow "Artifact" is produced. Sometimes we find only an Echo graphic shadow and other examinations are normal. In this case this is only an abnormal echo graphic finding.
This is why I recommended other examinations especially heart ECHO, CT and Angio CT. Angio Ct is a ct scan made with i.v contrast to better visualize blood vessels and this will help to exclude thrombus in IVC or in other veins (including pulmonary embolism). Also angio Ct will exclude any tumor or malignant disease.
Chest X ray is part of routine examinations before CT scans.
Wish you all the best!
Dr. Benard
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your clear answers.
You recommend an echo of the heart but this's shadow appeared during an echo of the heart. Did I misunderstand or would you repeat the echo of the heart?
What about an MRI which has no risk of radiation? Why did you not consider it?
How often do these artifacts appear in your experience?
Could I still pass a stress test with a clot or tumor?
You recommend an echo of the heart but this's shadow appeared during an echo of the heart. Did I misunderstand or would you repeat the echo of the heart?
What about an MRI which has no risk of radiation? Why did you not consider it?
How often do these artifacts appear in your experience?
Could I still pass a stress test with a clot or tumor?
Brief Answer:
I recommend transesophageal echo. ..
Detailed Answer:
Hi back,
As I mentioned earlier I recommend to do a transesophageal echo which is more accurate than transthoracic echo.
MRI and angio MRI should be done in patient who are of great risk from radiation. As a rule angio Ct is the best for lung structure. This is why I recommend angio CT.
The frequency of this artifacts depends from clinic to clinic and I can't give you a concise statistics. You can still pass a stress test in theory but practically you can't.
Wish you health!
Dr. Benard
I recommend transesophageal echo. ..
Detailed Answer:
Hi back,
As I mentioned earlier I recommend to do a transesophageal echo which is more accurate than transthoracic echo.
MRI and angio MRI should be done in patient who are of great risk from radiation. As a rule angio Ct is the best for lung structure. This is why I recommend angio CT.
The frequency of this artifacts depends from clinic to clinic and I can't give you a concise statistics. You can still pass a stress test in theory but practically you can't.
Wish you health!
Dr. Benard
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am asking the following questions as if I were your patient.
Are you saying that a shadow in the IVC could be coming from a tumor in the lung?
In other words, Why does the lung have to be checked?
You say Practically, I can't pass a stress test assuming clot or tumor. Ok, so why can't a stress test be a starter? If I were able to pass a stress test and have the echo -trans esophageal you recommend then would it be safe to conclude or surmise that there is no obstruction? I am looking to avoid that massive amount of radiation from a cat scan. In other words, I would hate to have all that radiation only to find out it was an artifact.
If I fail the stress test AND the shadow appears on the echotransesophageal then I would want the cat scan. How much of immediate danger could I be in if I can do strenuous workouts, lift weights and have ZERO symptoms? So why not do the stress test and echo FIRST And go from there if needed?
Aren't all patients really at risk for radiation?
Are you saying that a shadow in the IVC could be coming from a tumor in the lung?
In other words, Why does the lung have to be checked?
You say Practically, I can't pass a stress test assuming clot or tumor. Ok, so why can't a stress test be a starter? If I were able to pass a stress test and have the echo -trans esophageal you recommend then would it be safe to conclude or surmise that there is no obstruction? I am looking to avoid that massive amount of radiation from a cat scan. In other words, I would hate to have all that radiation only to find out it was an artifact.
If I fail the stress test AND the shadow appears on the echotransesophageal then I would want the cat scan. How much of immediate danger could I be in if I can do strenuous workouts, lift weights and have ZERO symptoms? So why not do the stress test and echo FIRST And go from there if needed?
Aren't all patients really at risk for radiation?
Brief Answer:
Angio-MRI advised as alternative to Ct-scan
Detailed Answer:
Hi back,
1. I have asked to run ct-scan of the lungs not because I suspect tumor in the lungs, but because, I'd like to rule out pulmonary embolism (PE) and to determine the nature of the shadow in the IVC.
2. If you are not keen to run Ct-scan, I'd advise to run angio-MRI.
3. I recommended not to run stress test as physical activity will increase chance for sudden death due to clotting of arteries or aggravation of PE.
These tests are necessary to run although you have ZERO symptoms.
4. Angio-Ct-scan does carry radiation risk, while angio-MRI is the alternative choice for non-radiation examinations.
Hope it helped!
Dr.Benard
Angio-MRI advised as alternative to Ct-scan
Detailed Answer:
Hi back,
1. I have asked to run ct-scan of the lungs not because I suspect tumor in the lungs, but because, I'd like to rule out pulmonary embolism (PE) and to determine the nature of the shadow in the IVC.
2. If you are not keen to run Ct-scan, I'd advise to run angio-MRI.
3. I recommended not to run stress test as physical activity will increase chance for sudden death due to clotting of arteries or aggravation of PE.
These tests are necessary to run although you have ZERO symptoms.
4. Angio-Ct-scan does carry radiation risk, while angio-MRI is the alternative choice for non-radiation examinations.
Hope it helped!
Dr.Benard
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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