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What Does This Stress Echocardiography Indicate?
Question: I recently had a echo stress test that revealed Possible ischemic echocardiographic response with left ventricular cavity dilation with exertion, Normal baseline ejection fraction of 73% and mild concentric left ventricular hypertrophy. I am having a heart XXXXXXX tomorrow. I am scared out of my wits that I may need bypass surgery. I do not have hypertension or high cholesterol.
Brief Answer:
Clinical conditions are satisfactory and feasible for every medical option.
Detailed Answer:
Hello!
Thank you for asking on HCM!
I understand your concern, and would like to explain that your doctor's conclusion seems to be reasonable.
Transient left ventricular cavity dilation during stress echocardiography is considered a sensitive marker of extensive coronary artery disease.
But it has just a moderate specificity (around 55%) for detecting severe and extensive angiographic coronary artery disease.
So, if stress echocardiography is not associated with induced wall-motion abnormalities, and an important wall motion score index, probably the transient LV cavity dilation lacks sufficient specificity to rule in an extensive coronary artery disease.
Nevertheless, waiting for the final tomorrow truth, I would confirm that your clinical scenario seems optimistic whichever be the medical management of your eventual coronary artery disease extension. Even on multiple coronary lesions, percutaneous angioplasty coupled with stent implantation may be a feasible option to follow.
If the conclusion is multi-vessel coronary artery disease and the final recommendation is CABG (surgery), again treatment expectations are quite high, as you have e fantastic left ventricular performance (EF 73%), without prior ischemic cardiac damages.
Hope to have been helpful to you!
Feel free to ask me whenever you need. Greetings! Dr. Iliri
Clinical conditions are satisfactory and feasible for every medical option.
Detailed Answer:
Hello!
Thank you for asking on HCM!
I understand your concern, and would like to explain that your doctor's conclusion seems to be reasonable.
Transient left ventricular cavity dilation during stress echocardiography is considered a sensitive marker of extensive coronary artery disease.
But it has just a moderate specificity (around 55%) for detecting severe and extensive angiographic coronary artery disease.
So, if stress echocardiography is not associated with induced wall-motion abnormalities, and an important wall motion score index, probably the transient LV cavity dilation lacks sufficient specificity to rule in an extensive coronary artery disease.
Nevertheless, waiting for the final tomorrow truth, I would confirm that your clinical scenario seems optimistic whichever be the medical management of your eventual coronary artery disease extension. Even on multiple coronary lesions, percutaneous angioplasty coupled with stent implantation may be a feasible option to follow.
If the conclusion is multi-vessel coronary artery disease and the final recommendation is CABG (surgery), again treatment expectations are quite high, as you have e fantastic left ventricular performance (EF 73%), without prior ischemic cardiac damages.
Hope to have been helpful to you!
Feel free to ask me whenever you need. Greetings! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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