Would Aortic Regurgitation Show On Chest X ray Or EKG?

[jackadams]

Hi,

I am 25 years old. To make a long story short im going to tell you what happened to me at the ER. I had a sudden quite severe pain between my shoulders that came out of nowhere that would not go away. So I went to the ER because I have some of the symptoms of Marfans but all of the docs say I dont have it, yet I was scared I could so I went.

When getting to the ER my blood pressure was very high (as usual). I have what they call white coat syndrome but had a really nervous visit that night as my bp was around 220/110 but fell to 158/85 once I settled down 15 minutes later. Although I was still very nervous my BP was still a bit high (I have major aniexty problems at the doc). My diet is around 6 double cheeseburgers at mcdonalds and also 2 large domino pizzas and I never eat veggies or fruits. But im changing my diet now and im only eating healthy.

Anyways the doctor was amazed at how stress raised my BP and it lowered once I payed down for 10 minutes. Anyways at first he thought I had a aortic dissection for sure. I must also mention I have MVP and a heart mumur. So he did a EKG, chest x ray and Ct scan.

All of them came back normal and my aorta size was in the normal range also. But what concerns me is before he did all of those test he listened to my heart beat with a stephoscope and said he heard aortic insuffiency which signaled aortic dissection to him.

He rushed off after all of those test and came back and said "well everything looks normal, you sure could have folled me though." But now im wondering if I could still have Aortic Regurgitation since ive read the best way to detect it is with a echocardiogram.

But if I had Aortic Regurgitation wouldnt my aorta root been enlarged on the CT scan and also wouldnt it have shown up on the Xray and EKG perhaps? Also how realibale is just hearing the Aortic Regurgitation on the stephoscope, I mean is it very easy to distinguish from a regualr heart mumur associated with MVP?

If anyone can give me any advice I would be thankful. I must also say I have had high BP since say 15 but it goes down alot at home. Thanks in advance :)

[jackadams]

Thanks alot! Exactly the info I was looking for. 35% accuracy isnt that great, hopefully my echo wont show anything too bad. Like you said, if its mild it may never cause problems. Thanks again for the great answers and patience :)

[kenkeith]

Many mechanisms contribute to aortic valve insufficiency. A CT scan would have images of abnormal aortic valve leaflets and any pathologies of the proximal aortic root.

A poorly functioning or insufficient aortic valve can be identified when a doctor listens to the heart during a physical examination. A chest x ray, an electrocardiogram (ECG, an electrical printout of the heart beats), CT scan  as well as an echocardiogram can further evaluate or confirm the condition.

An echo (doppler) color codes the blood flow through the heart in red and backflow due to regurgitation, etc. is the color green.  The height and direction of the backflow helps calculate the degree of regurgitation and location.  I observed my echo monitor and given an explanation during the test.

Studies have shown that heart auscultation (tethoscope)  findings were in poor accordance with echocardiographic findings and had high interobserver variation.

Results of one study:
"Doctors using the advanced stethoscope diagnosed 35% of the patients correctly, as compared with doctors using the simple stethoscope who did 33% of the patients (P = .27). Similarly, 34% of the patients were diagnosed correctly by doctors who had received teaching as compared with 33% of those who were by doctors who had received no teaching (P = .41).  Requires further evidence to make a diagnosis.

In addition there are INNOCENT murmurs and there pathological murmurs.  You may have an innocent murmur heard by stethoscope or a murmur of valve insufficiency may be trivial or mild and have no medical significance and never progress.

[jackadams]

Thanks! So the CT scan I did should show my aortic heart valve right? So if it looks normal then odds are I do not have aortic insuffiency? I have read also that aortic insuffiency may not even need surgery if its mild, just watch and perhaps never need surgery for the rest of your life.

So if my heart valves look good on a CT scan that still can not show reguration right? Thanks again.

[jackadams]

Thanks for the answer :) I know I do not have an aortic dissection, im worried about aortic reguration. Do you think the doctor would be able to accurately no matter what hear it with a stephoscope?

Im just wondering if he could have been wrong with only diagnosing it with a setphascope. If anyone has some feedback on this I would love to hear it. Thanks :)

[martikadragoon]

I believe the easiest thing to find regurg. would be an Echo. that should work.

If you had an aortic dissection you'd likely be dead or dying or VERY VERY sick. Because from what I've read ppl die from that quite a bit if it happens to them. IDK if I'm completely right so someone correct me if i'm not. my son had 2 ASD/1HUGE VSD repair on 11/4 so I've done some homework. (his lungs were flooded w/bloodflow)

[jackadams]

Thanks guys, but if the doctor heard Aortic reguritation with the stephoscope could he be wrong still? I mean he also thought he heard my aorta dissecting but was wrong about that.

Im getting an echo cardiogram done here soon. Just wanted some information until I can get it done. I had 1 done about 5 years ago and all was normal :)

[agentsl9]

Echo is used to review the function of the heart. See a cardiologist. Tell him what's happening. He'll tell you all about risk factors and what it's most likely not. A good cardiologist will do all the tests, echos, stress tests, etc. Make them find what's wrong.

[jackadams]

Thanks, but they ruled out dissection. The EKG, chest x ray and CT scan looked normal as far as my aorta goes. But it was only with the stephoscope that the ER doctor heard the heart mumor assoicated with Aortic Reguritation/Insuffiency.

So I guess my main question here is if aortic reguritation show up on any of these test or do I need a echocardiogram? Also how accurate can a doctor be in diagonising aortic reguritation with only the stephoscope? Also from what I read aorta regurgitation can be dangerous and almost always requires sugery with time?

Thanks so much for your answer, looking forward to your reply :)

[kenkeith]

A stethoscope murmur and an EKG require further testing to verify findings.

A CT scan 64-slice is as good as a cath angiogram.  The CT scan also can find problems with heart function and heart valves. A CT scan takes images of the aorta vessel (ascending, arch, and descending as well as the repiratory system.

Aorta dissection is a rupture of the vessel.  A murmer is an abnormal sound usually due to valve leakage (which is not uncommon).  Regurgitation is backflow of blood into the left ventricle rather than pumped into the system and that can be associated with MVP (mital valve prolapse...leaflets fail to close of the backflow of blood) and oftened considered medically insignificant.