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Heart Disease (Expert Forum)
Accuracy
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Accuracy
by Pam, Jun 05, 2000 12:00AM
A reply on this forum said an echo cannot overestimate the degree of valve regurgitation. Is this true? My echo showed mild mitral, mild aortic, and trace tricuspid regurgitation. I take toprol (I think to slow my heart rate) and triam/hctz for swelling. I have shortness of breath, feet and ankle swelling, and fatigue. My cardiologist doesn't feel the above degrees of regurgitation would cause these. I'm having a heart cath tomorrow to rule out PPH. I'm wondering is it possible my echo underestimated (or overestimated) the level of regurgitation. I'd much rather have worse regurgitation than PPH. Pam
Doctor's Answer
by CCF CARDIO MD - CRC, Jun 06, 2000 12:00AM
Dear Pam,
Yes and no. In general echo does not underestimate valvular regurgitation but in some cases it may. If there not a good image, for example in someone who is very heavy or has poor echo images, then the regurgitation may be underestimated. Sometimes in these circumstances the doctor will perform a transesophageal echocardiogram (TEE) which is almost always accurate. For the most part however echo accurately accesses the degree of regurgitation.
Yes and no. In general echo does not underestimate valvular regurgitation but in some cases it may. If there not a good image, for example in someone who is very heavy or has poor echo images, then the regurgitation may be underestimated. Sometimes in these circumstances the doctor will perform a transesophageal echocardiogram (TEE) which is almost always accurate. For the most part however echo accurately accesses the degree of regurgitation.
You can e-mail me at ***@**** If you want to compare stuff.
that's a 25% variation in and of itself!) it could very well overestimate and underestimate the leakage.
When my cardiologist was not satisfied with the readings he got on my echo and then stress echo (which mimicked a biscuspid valve), he ordered the cath and that led to AVR within 9 months(the cath showed a a Left Ventricular wall contractility that was less than normal, confirmed the 3-4+ leak, and the bicuspid functioning and some calcification of the Aortic Valve).
The other test they could use is the TEE, a very uncomfortable, to say the least, experience if you are not 'out' for it. But it will provide good information without invading the circulatory system.
describes it, when he got it with a local, far better than I can and it is brutal.
See his Chronicle on the 'Cachnet' website. If you need the URL
let me know.
Whether Catheter is better or TEE, the advantage of the Catheter is that they can assess the status of the CAs at the same time they measure the leakage in the valves. That advantage comes with the risk of any arterial invasive procedure: knocking something loose with predicatable consequences.