Dr. Ilir Sharka
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 33-year-old female. I am generally fit and not obese. My doctor suggested a CT scan for my heart. I am worried about the amount of radiation and contrast dye I will be exposed to. Are there any other tests I can do? And is this test too critical with my other findings? Symptoms started with lower back and pelvic pain, then after a few weeks of abdominal pain, and at the end of my shoulder, sometimes my arms both right and left. I have difficulty in breathing. Pulsating pain in the left side of the body, which moves around. Tinnitus and hemorrhoids on the left side, too. Two episodes of blood in sputum, which lasted for one day each, with one week gap between events back before three months. It did not recur since then. Occasional ketones and blood in urine at the onset of symptoms. Test results are follows. ECG shows incomplete RBBB. ETT shows depression up-sloping. Echo (taken before seven years) shows mild tricuspid regurgitation. Total cholesterol is 183 mg/dL. Triglycerides is 70 mg/ dL. HDL-Cholesterol is 73 mg/dL. LDL-Cholesterol is 96 mg/dL.
Hello,
Welcome on icliniq.com.
I passed carefully through your medical history and would like to explain that your symptoms (migrating and pulsating pain) seems nonspecific for any cardiac issue. Also, you have no apparent coronary risk factors (your lipid profile is fine with no known hypertension, you should check your blood glucose level) and your already performed cardiac tests are almost normal. There may be a cardiac CT with a high probability would result healthy without providing any decision making information (you are not in an intermediate pretest probability). Another reasonable and safer diagnostic alternative is cardiac magnetic resonance imaging test (CMR), it utilizes gadolinium-based contrast, which is more benign. You should discuss with your doctor about the issues mentioned above. I hope to have been helpful to you.
Patient's Query
Thank you doctor,
Do any of these tests (ECG, ECHO, and CT) rule out aneurysm? If not, how is aneurysm to be diagnosed?
Hello,
Welcome back to icliniq.com.
Echo may detect aortic root aneurysm, sometimes the aortic arch and also descending and abdominal aorta aneurysm. Angio CT is perfect for such reason, but remain the issues of radiation and iodinated contrast. From the other hand, cardiovascular magnetic resonance imaging test is perfect at detecting possible aortic aneurysm and any other alternative causes responsible for your complaints.
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Cardiology
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