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Dr. David
Dr. David, Doctor
Category: Cardiology
Satisfied Customers: 43910
Experience:  Experienced physician with cardiology experience
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I recently had a stress test and would like to ask a few

Customer Question

I recently had a stress test and would like to ask a few questions:
1. What does: "Bacterial endocarditis prophylaxis is not recommended" mean?
2. Should I be concerned with the following findings:
a) "is mild mitral leaflet thickening. There is a trivial amount of mitral regurgitation"
b) "There is trivial tricuspid regurgitation"
Is there anything additional that is concerning, or is this a normal stress test?Below is the details from the test:
Stress EchocardiogramDiagnosis:
* ICD-10-PCS Palpitations (R00.2)
* ICD-10-PCS Dyspnea, unspecified (R06.00)CPT Code(s):
* Doppler Full (93320)
* Color Doppler (93325)
* Stress Echo (93351)Indication:
DOE/PVCsStage BP HR
Rest 112/80 70
Peak 137/80 153
Recovery 120/80 78Summary:
1. This is a negative electrocardiographic stress test.
2. This was a negative echocardiographic stress test.
3. No PVCs or PACs during stress test.
4. Probable pericardial cyst noted although unable to define it well for
certenaity.
5. The EF is estimated at 55-60%.
6. There is mild mitral leaflet thickening.
7. There is a trivial amount of mitral regurgitation.
8. There is trivial tricuspid regurgitation.
9. No pulmonary hypertension is noted.
10. There is a trivial amount of pulmonic regurgitation.
11. There is no pericardial effusion.
12. No evidence of thrombus.Recommendation:
1. Bacterial endocarditis prophylaxis is not recommended.
2. A Cardiac MRI is recommended. for follow up pericardial cyst noted
on CT chest in 1 year.Predicted Values:
The patient achieved a maximum heart rate of 153 which is 87% of the
maximum predicted heart rate (176 beats/min). The target heart rate was
achieved.Findings Rest
Technical Comments:
The study quality is fair.Left Ventricle:
The left ventricular chamber size is normal. There is normal left
ventricular systolic function. Global left ventricular wall motion and
contractility are within normal limits. The EF is estimated at 55-60%.Left Atrium:
The left atrial chamber size is normal.Right Ventricle:
The right ventricular cavity size is normal. The right ventricle wall
thickness is normal. The right ventricular global systolic function is
normal.Right Atrium:
The right atrial cavity size is normal.Aortic Valve:
The aortic valve is trileaflet. There is no evidence of aortic
regurgitation. There is no evidence of aortic stenosis.Mitral Valve:
The mitral valve leaflets appear normal. There is mild mitral leaflet
thickening. There is a trivial amount of mitral regurgitation. There is
no evidence of mitral stenosis.Tricuspid Valve:
The tricuspid valve leaflets are morphologically normal. There is
trivial tricuspid regurgitation. There is no tricuspid stenosis. The
Right Ventricular Systolic Pressure is calculated at 22mmHg. No
pulmonary hypertension is noted.Pulmonic Valve:
The pulmonic valve is not well visualized. There is a trivial amount of
pulmonic regurgitation. There is no pulmonic stenosis present.Pericardium:
There is no pericardial effusion.Aorta:
The aortic root appears normal.Venous:
The inferior vena cava appears normal.ECG:
Normal sinus rhythm. First degree AV block.Miscellaneous:
No evidence of thrombus.Recommendations:
Bacterial endocarditis prophylaxis is not recommended.
Findings Peak
Stress:
At peak stress image quality was good. At peak stress the LV chamber
size becomes smaller. With peak stress the global left ventricular
function becomes hyperdynamic. Patient followed a Bruce protocol. The
patient exercised into stage 4. The total exercise duration was 10
minutes. The study was terminated because of fatigue. Normal sinus
rhythm. Sinus tachycardia. There are non-specific ST-segment changes.
The patient did not express feelings of chest discomfort. The blood
pressure response is adequate. Exercise capacity is good. The patient
achieved a level of 12 METS. There were no arrhythmias. This is a
negative electrocardiographic stress test. This was a negative
echocardiographic stress test.Recommendations:
A Cardiac MRI is recommended. for follow up pericardial cyst noted on CT
chest in 1 year. The above results were discussed with the patient.Measurements
Chambers
Name Value Normal Range
IVSd (MM) 0.9 cm (0.6 - 1.1)
IVSd (2D) 1.1 cm (0.6 - 1.1)
LVIDd (MM) 5.3 cm -
LVIDd (2D) 5.5 cm -
LVIDs (MM) 2.5 cm (2.2 - 4)
LVIDs (2D) 3.4 cm (2.2 - 4)
LVPWd (MM) 1 cm (0.6 - 1.1)
LVPWd (2D) 1.1 cm (0.6 - 1.1)
Ao root diameter (MM) 3.2 cm -
Ao root diameter (2D) 3.4 cm -
LA dimension MM 3.8 cm (2.7 - 3.8)
LA dimension 2D 3.7 cm -
LA area 14 cm2 (<21)
RA area 12 cm2 (<18)
EF Teichholz (MM) 60 % -Tricuspid/Pulmonic Valves
Name Value Normal Range
RVSP 22 mmHg -Volumes
Name Value Normal Range
LV EDV SP 4CH (MOD) 34 ml -
LV ESV SP 4CH (MOD) 20 ml -
EF SP 4CH (MOD) 55 % -
Submitted: 11 months ago.
Category: Cardiology
Expert:  Dr. David replied 11 months ago.

this is Dr. David

1. prophylaxis means prevention. some patients who have plaques or growths on the leaves of their valves or artifical valves can be at risk for bacterial infection of the heart called bacterial endocarditis. oral antibiotics are needed for those patients sometimes if they get dental procedures or other procedures which can spread bacteria into the blood.

2. no, these findings are not worrisome.

your heart EF or ejection fraction or efficiency of your heart is normal.

there is nothing to worry about with this heart ultrasound

let me know if you have other questions.

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