strange echo results

[nate_c]

Hi, All. Trying to do some research on some strange echo results from my last check-in. I didn't have a doc appt with this echo - just the test - so I haven't had a chance to ask questions, but I'm going to try to schedule follow up. I'm curious if anybody knows how to interpret these findings. Here are the things I saw on this report that I'd never seen before (and I've been getting echos since I was 11):
- Mild mitral calcification. Mild tricuspid regurgitation.
- Mild RV enlargement. Abnormal IVC dynamics
- Low normal RV systolic function
My problem has always been with the LV and the aortic valve, so I'm puzzled by these issues on the right side. I've never had any problems with the RV before. Any insights would be much appreciated. I'll add that I did have a congenital valve defect - the main reason for the AVR - but I also had rheumatic fever as a kid. As I've been thinking about this, I've been wondering if maybe these other problems stem for the illness.

 

[Julian]

Im no doctor but in general I dont see anything too alarming. Echos just give a general picture of the heart in motion. The results from an echo can minimize or exaggerate things. If there was a serious question of something serious I would have another echo done by a different tech. If that still doesnt work then lets do a TEE. First step is to make a follow up appointment with the cardio and have him or her explain what it all means or can possibly mean.

 

[Bill B]

So, you got a copy of one cardiologist's interpretation of your echo. Another cardiologist might read it differently. Another cardiologist might focus on other things and not report these findings at all. I see this kind of thing all the time - different interpretations and different aspects of my heart's performance reported on different echos. It's not so much due to the particular tech's skills (and they don't prepare the report) as it is to variability in the interpreting cardiologist. Next time you see you cardiologist, ask him why these showed up now and not on other reports.

 

[Superbob]

This has been my experience with echoes, too -- a lot of variability in how they are interpreted. Also, the adjective "mild" in your report should be reassuring. When it gets to "moderate" or of course "severe," that's when the red warning flags go up. I would definitely seek a follow-up appointment and ask for a detailed explanation. I believe that there is usually a follow-up visit after an echo -- certainly there should be one.

An echo is a useful tool in monitoring the heart's functioning, but if there is indication of a problem, more exact imaging like a C-Scan may be in order.

 

[Bill B]

BTW, I think it does more harm than good to send these reports to patients without an opportunity to go over them directly and resolve confusion such as this. I was mildly worried for months after seeing the same kind of unexpected anomalies appear out of the blue on one report, even though I knew that echos, like X-rays, MRI's, and numerous other tests are "interpreted" somewhat variably. In my case, it appears that various cardiologists rotate through the job of interpreting echo results in the medical group, and different eyes focus on different things. This appears to be common. When I finally had my annual appointment with my cardiologists, I spent 20 minutes going over all the spurious stuff with him that I had seen before I believed his dismissal of most of these findings as not significant. In a few instances he looked at who read the echo and admitted that that cardiologists was not particularly good at reading that part of the echo, and he relied more on his physical exam to assess whether the interpretation was consistent with my condition.