Not sure what this means?

Not sure what this means either

by Gemita - 2023-05-29 19:22:26

Hello Hayden,

I can understand you are puzzled and concerned about what you have read.  Strange you have only just discovered this letter?  Have you really not seen it before?

I would ask your GP about this and perhaps they might contact the Great Ormond Street Hospital (GOSH) to confirm the findings from their letter from last November?  

Clearly your present hospital haven't confirmed “significant aortic dilatation” in your recent echo which is reassuring but this still needs follow up or explanation.  In the meantime Hayden, there is no point is discussing aortic dilatation until we know for sure whether you have this problem since it would only lead to unnecessary concern.  But do speak to your doctors about this before filing the letter away and please let us know what action, if any, needs to be taken?

How are things otherwise.  Are you feeling any better?  I do hope so

Echo

by Penguin - 2023-05-30 04:42:36

Hi Hayden, 

I agree with Gemita. 

Re: the letter. Often echo letters contain a lot of lingo that we have to look up in order to understand what is being said. It would be so much easier if these reports had an explanation of the terminology used, so that we don't have to resort to Dr Google to explain it.  I've received an echo report before now which I'm told is nothing to worry about and yet if I look up the terminology it paints a picture I don't like.  In those circumstances I usually park the concern and assume that there's some subtlety or other that Dr Google hasn't explained that means it's not as serious as it appears.  I've trusted what my doctors have told me.

If you are concerned contact the Patient Advice & Liaison Service (PALS) at GOSH to see if they can help you.  PALS don't deal exclusively with complaints they deal with queries too.  Tell them that you seem to be getting contradictory information e.g. one hospital (JR) says that all is fine, yet the echo letter from GOSH has this terminology in it which appears to be concerning and that you;d like to have the findings explained. 

Perhaps ask what 'significant aortic dilation' means, why it occurs and whether it is having an impact on how your heart functions currently or whether it may have an impact in the future.  Is there anything you should be aware of in terms of symptoms?

Word of warning PALS operatives do seem to be working from home a lot since the pandemic and the lines may be answerphones in the first instance.  

terminology

by Tracey_E - 2023-05-30 09:59:30

It can be in good shape but still not textbook perfect. Sometimes they keep an eye on it but are not currently concerned, sometimes it doesn't fall within normal parameters but it's nothing they are worried about.

Any test results are like that if you look too closely. I was recently reviewing my latest bloodwork and was shocked how many of the numbers were red (not in normal ranges) but there was only one or two my doctor even mentioned he was watching, none he wants to do anything about. If he's not worried, I'm not worried. He's got the degree so I trust him over google.

aortic dilation versus stenosis

by Julros - 2023-05-30 11:16:11

Hi Hayden, 

I agree with the others about not getting too hung up on the terminology in that letter. Its possible its even a transcription error. I would follow up with you GP. 

I will point out that there is a difference between dilation and stenosis. Dilation or dilatation means that something is increasing in diameter. For blood vessels, this could be caused by a weaking in the wall, allowing the vessel to expand.

Stenosis is nearly the opposite. Aortic stenosis usually refers to the aortic valve getting stiffer and not opening as well. This is usually an age-related condition, which does not seem to apply to you. 

On my echos, they measure both the aortic root, where the aorta leaves the heart, and my abdominal aorta, just above the renal (kidney) arteries. 

Echo results/terminology

by Sparky10 - 2023-05-31 22:20:00

I would echo (pun intended) what others are saying. I'm a recent addition to the ICD club, but am a nurse anesthetist who has read many, many echo reports for my patients over the years. Study results can vary greatly for many reasons- transthoracic vs transesophageal, positioning issues, body habitus variables. Both issues would be ones to watch if they were truly believed to be present, but also good conversations to have with your provider to see if the visualization quality during the exam was optimal. It is not uncommon for things to show up/not show up on echos that have the potential to be clinically significant, or not significant. I think if you have posed the questions to your provider, they are reassuring you, and you have a good rapport or trust w/ your provider, you should be okay.
 

Aortic dilation can be somethint to watch-- progressive increases in size could lead to eventual rupture or bleed, but many people live w/ widening of their aorta in surveillence mode and just monitor to make sure their BP doesn't get too high.  Aortic stenosis is very different, and is a narrowing of the outflow from the heart, and frequently coincides w/ higher BPs that are favorable for maintaining blood flow to the coronary arteries (entrance to them is just past the aortic valve.