Yikes! Today's Echo

[DavesMom]

Hi everyone,

Went for my yearly echo today (I had AVR/aneurysm repair in '99) and after years of perfect reports, the following things were noted that the doctor who wrote the report said should be "considered for TEE if clinically indicated."

I have a CT scheduled to check my aneurysm and then an appointment with my cardio at the end of the month. Can any of you shed a light on what any of what these mean? Everything else seems fine.

"A 0.6 x 0.4 cm independently mobile echodensity on the aortic side of the prosthesis. Differential includes vegetation (in the appropriate clinical setting, e.g. fever, bachteremia, etc.) An echodensity is also noted on the atrial side of the mitral valve on one still picture."

"On the right ventricle, a linear mobile echodensity is also noted in the RVOT which most likely represents a chordal structure."

I knew something was up when the tech said she saw "something shiny" on my valve. She said it might've just been a shadow but to be safe, she had my test read before she'd let me leave.

If it is indeed vegetation, can this destroy the valve?

Thanks in advance for any information and hope everyone is well. Cheers!

 

[karla]

I think I can help with some of it...."Differential" means "possible diagnosis or something to consider or think about". The reading doctor is telling your doctor that he sees something but is not entirely sure what it is. He is asking your doctor if you are sick ( is there a fever? is there bacteria in the blood?) and suggesting that if you ARE sick, what he sees MIGHT be vegetation that could indicate endocarditis. He is suggesting that if you have signs of illness, a TEE ( trans-esophageal echocardiogram) would show more and would be more accurate in order to come up with a correct diagnosis.
Are you feeling anything out of the ordinary?

 

[DavesMom]

Hi Karla,

Thanks so much for the reply. No, not really feeling any different, which is why I thought all this was very odd to read this on the report. Only thing I can say is that I have sharp pains sometimes but I think they're more muscular in origin.

Funny thing is they always have a tough time seeing my valve on the echo (I also have a 21" mechanical) : ) so maybe it was just some sort of shadow or something. Who knows? I do have a CT towards the end of the month so we'll see what that says.

Thanks again!

 

[sarahsunshine]

It sounds to me like the reader was saying "I think I saw something and don't know what it is, but not sure". TEEs are not fun, but they really give much better information. a TEE is really the only way they could get any accurate data on my step-son's valves, foming back 3 times as "looks good, nothing to worry about". For most monitoring, Echos work well and are minimally invasive, but they are not very accurate. This is probably why the Echo reader said "considered for TEE if clinically indicated."

 

[karla]

Hi Karla,

Thanks so much for the reply. No, not really feeling any different, which is why I thought all this was very odd to read this on the report. Only thing I can say is that I have sharp pains sometimes but I think they're more muscular in origin.

Funny thing is they always have a tough time seeing my valve on the echo (I also have a 21" mechanical) : ) so maybe it was just some sort of shadow or something. Who knows? I do have a CT towards the end of the month so we'll see what that says.

Thanks again!

Be sure to let us know the final outcome. If the report is really bothering you, no reason not to call your cardio and ask about the report before the end of the month.....as they say, that's why they get the big bucks!

 

[DavesMom]

sarah, You are so right - I've had a TEE and they are NO fun at all. Hope I don't have to go through another. I do think most of the problem is the tech couldn't get a good view of the valve so the doctor who read it can't be sure of what he saw.

karla - Will post back when I learn more. I'm somewhat tempted to call but since I don't feel bad I'll let it go. I'm assuming it would show up on my CT scan as well. Odd that they're only able to see my aneurysm on the CT (never shows up on the echo, though today the tech said she could see a little bit of it) but luckily, it's been steady at 4.4 since they found it three or four years back.

Thanks again and take care! Cheers!

 

[Guest]

I'm somewhat tempted to call but since I don't feel bad I'll let it go.

It might ease your mind a bit to call anyway. Or, if you are able to send an Email or a message electronically via a website, you could do that, too.



Cort | 38.m.IL | pigValve + paceMaker + cowValve | 5 MCs + 1 Caprice Classic
CHD.MCs.CC + RoadTrips.hobbies.RadioShows.us66 = http://www.chevyasylum.com/cort
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"Every hands a winner & every hands a loser" __ Kenny Rogers __ 'The Gambler'

 

[karla]

My aneurysm didn't show with an echo, either, so I had a great big surprise when I had my preop cath done. Oh well, it all worked out great.
Take care.

 

[DavesMom]

knightfan - I have to call the nurse about my upcoming CT anyway so will ask about it. Wish I could email, but our doctors don't do that.

karla - Same here! They found an aneurysm during the cath I had just before my AVR in '99 and lucky me, now I've got another. : ) I hope it's stayed stable again this year because moi does not want surgery numero tres.

Take care, everyone.

 

[Guest]

knightfan - I have to call the nurse about my upcoming CT anyway so will ask about it. Wish I could email, but our doctors don't do that.

Ah, sorry that they don't. It is rather convenient.

Good luck! Thoughts/prayers continuing....



Cort | 38.m.IL | pigValve + paceMaker + cowValve | 5 MCs + 1 Caprice Classic
CHD.MCs.CC + RoadTrips.hobbies.RadioShows.us66 = http://www.chevyasylum.com/cort
* rNw-CC+event: http://rdwhl-capriceclassic.proboards.com/index.cgi?board=whatsgoingon *
"The rhythm of the rails is all they feel" __ Steve Goodman __ 'City Of New Orleans'

 

[DavesMom]

Hi knightfan,

I also wish my cardio had email. I hate to say it, but I haven't really trusted her nurse since she called me after the first CT and said it was "fine" but that I'd start having yearly CT scans. She failed to mention, however, that I had an aneurysm! Wouldn't have known had I not gotten a copy of the report. She also had me drink barrium for that first CT and when I showed up for the test they told that it was unnecessary. And barrium is super nasty stuff.

Thanks for the good thoughts. Right back at ya. : )

 

[Guest]

Hi knightfan,

I also wish my cardio had email. I hate to say it, but I haven't really trusted her nurse since she called me after the first CT and said it was "fine" but that I'd start having yearly CT scans. She failed to mention, however, that I had an aneurysm!

If you don't me asking, who is your cardio? Your cardio's nurse sounds a lot like my cardio's NP. When she called me for the results of my Holter Monitor, she said, "Everything looks good, so you have to see an EP right away." She failed to tell me that my cardio just wanted me to follow up with an EP, with no urgency per se, since the results of the monitor at my Cardiac Rehab only showed the ONE instance/event.

My cardio doesn't exactly have Email ... it's through the foundation's website....


And, thank you!



Cort | 38.m.IL | pigValve + paceMaker + cowValve | 5 MCs + 1 Caprice Classic
CHD.MCs.CC + RoadTrips.hobbies.RadioShows.us66 = http://www.chevyasylum.com/cort
* rNwJumpStartCruzNite | 5:30-10:30p; SAT, 05/12/12 | BeefVilla, 1225 W Spring St, S Elgin IL *
"And the simple truth so very much clearer" __ Everything __ 'Hooch'

 

[DavesMom]

Hi knightfan,

I live down in the central part of the state (aka the part of IL that doesn't matter) : ) so I doubt we have the same cardio. I do like my cardio but her nurse, while a very nice person, drives me crazy. That's why I've become fanatical about getting copies of my reports - the nurses don't always tell you everything.

Take care!

 

[njean]

Just wanted to wish you well with your upcoming CT scan. Keep us informed.

Good luck!

 

[Guest]

I live down in the central part of the state (aka the part of IL that doesn't matter) : ) so I doubt we have the same cardio. I do like my cardio but her nurse, while a very nice person, drives me crazy. That's why I've become fanatical about getting copies of my reports - the nurses don't always tell you everything.

Yep, they don't.

And, I don't know ... central IL has some pretty neat places, some associated with Route 66!





Cort | 38.m.IL | pigValve + paceMaker + cowValve | 5 MCs + 1 Caprice Classic
CHD.MCs.CC + RoadTrips.hobbies.RadioShows.us66 = http://www.chevyasylum.com/cort
"There's things goin' on make me mad down to the core" __ Charlie Daniels __ 'Simple Man'

 

[carolinemc]

Sounds ike the problems we usually have are with the doctor. This is with the nurse or receptionist, there is always not a good following the doctor orders with them. They can also say that you cannot see the doctor in three days, you have to wait three weeks. My mother had that problem for her RA. Never changes, always the same. Frustation. Hope your CT goes well. Hugs for today.

 

[DavesMom]

Hi all,

Thanks for the good wishes. My CT scan is next week so will update then. I'm sure I'll be at the clinic the next day getting a copy of my report. ; )

knightfan - Yeah, there are some decent places down here (I don't live near 66) but it does seem that Illinois is divided into Chicago and "downstate." There was a big brouhaha with our state insurance plan last year because the legislature was offering options that would've left us downstaters with only two options - one that had VERY few providers in our area and the other that was super expensive. It all worked out in the end but it was a major mess.

Take care!

 

[DavesMom]

Hi all,

Just wanted to give an update and ask a couple of questions. The doctor who read the echo I had a couple of weeks ago basically said he thought he saw something but wasn't sure what. : ) I don't think it could be an infection cause I've been feeling fine.

So I was hoping the CT scan I had last Friday would bring some clarity. Got the report this morning and there are a few things that I found odd.

First, it said that accurate measurements were somewhat difficult because of "significant step off artifact and motion degradation." What the heck are these? Could the artifact be what the doctor who read my echo saw?

Also, the ascending aortic aneurysm has gone from 4.4 cm last year to a "maximum of 4.5 cm" this year. However, the doctor then notes that "this is without significant interval change." This may sound like a stupid question, but is he saying there hasn't been significant change? (The word "interval" is what gets me there.) Isn't a growth of a cm quite a lot in a year?

Still have aneurysms in the great vessels (brachiocephalic, left common carotoid, and subclavian) that are "without significant change overall." That's good news.

Anyone have any insight on this? Seeing the cardio soon but I always wonder about these things. : )

Hope everyone is well and thanks in advance for any input.

 

[Garserin]

DavesMom, the rate of growth during the last year was only 1/10 of one centimeter, not a whole cm. I hope that makes you breath a little easier.

 

[DavesMom]

Thanks, Garserin. DUH! I'm not a stupid person - except when it comes to math. : ) Well, it's stayed at 4.4 for several years so I wasn't happy to see any sort of change. However, on the whole I think the report looks pretty good so I'm happy.

Thanks again!