What Do The Attached CT Scan Reports Indicate?

Posted on Thu, 12 Oct 2017

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 12 Oct 2017 Answered on

Wed, 8 Nov 2017 Last reviewed on

Question : plz help me interpret these ct scan of the chest results ....
there are multiple filling defects in segmental and subsegmental branches going to the lingula and the left lower lobe. there is a bovine Arch. the rv to lv ratio is less than one. there is minimal pericardial effusion. there are atelectatic changes at the lung bases. there are mild degenerative changes at the thoracic spine

Answered by Dr. Drkaushal85 (7 hours later)

Brief Answer:
Possibility of pulmonary embolism is more likely.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
I have gone through the report you have mentioned.
I just want to confirm that this report is of CT pulmonary angiography. Am I right?
Multiple filling defects in segmental and subsegmebtal branches is classical of pulmonary embolism (PE).
RV (right ventricle) /LV (left ventricle) ratio is less than 1. This means right ventricular strain is not there.
Usually PE causes pulmonary hypertension and right ventricular strain. So size of right ventricle increases and RV/LV ratio becomes more than 1.
Sincr this ratio is less than 1,no need to worry for right ventricular strain.
Pericardial effusion is mostly secondary to embolism.
Atelectesis (partial collapse) is also due to reduced blood supply due to embolism.
So please let me know
1. Is this CT pulmonary angiography report?
I will be happy to help you further. Wish you good health. Thanks

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Drkaushal85 (9 hours later)

yes. it is a pulmonary angiographt report

Answered by Dr. Drkaushal85 (1 minute later)

Brief Answer:
Possibility of pulmonary embolism is more.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Possibility of pulmonary embolism is more likely.
Please let me know details of patient like age, sex, symptoms etc so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Drkaushal85 (4 hours later)

I Was diagnosed with 2 embolisms and hospitalized gor a week on heprin and sent home on cumodin. I'm having tingling in my arms and legs that comes and goes, pain in my chest and back, coordination problems and numbness in different parts of my body, especially my chest that comes and goes. I'm feeling confused. when I was initially admitted I had stroke symptoms and couldn't speak or find the right words to finish sentences and shaking all over and numbness in my face and drooping on one side. what could this indicate. I would like to mention that there is a history of lung cancer in my family. my mother passed away at a young age from it. thank u so much for ur help doctor

Answered by Dr. Drkaushal85 (53 minutes later)

Brief Answer:
You might be having embolism of brain vessel.

Detailed Answer:
Thanks for your follow up question.
I can understand your concern.

The symptoms you are describing are more suggestive of stroke.
Most probably stroke is due to embolism in brain vessel.

Have you undergone MRI brain at that time?
Also, please tell me what is the cause for your embolism?
Do you take oral contraceptive pills?
Do you have DVT (deep venous thrombosis) of leg veins?
Do you smoke?

I will be happy to help you further.

Wish you good health.
Thanks.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Drkaushal85 (5 hours later)

there is no evidence of dvt and I do not take birth control pills but I am a smoker. there was an mri done but without contrast. I did get more Medi-Cal records today from my hospital visit lastnight and I have a few questions about my EKG results. this is exactly what it says......
minimal St depression, inferior leads
baseline wander in leads I II avl
what does that mean plz. and again I really appreciate ur help

Answered by Dr. Drkaushal85 (4 hours later)

Brief Answer:
STdepression means possible ischemia.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Significant ST depression means ischemia.
Leads I II and avl, correspond to inferolateral wall of heart.
Only significant depression suggests ischemia.
Non significant depression can be seen normally.
So please send me your ecg to guide you further.
Also tell me why you visited hospital last night? Did you have chest pain?
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Drkaushal85 (8 hours later)

I have been experiencing constant chest pain, especially on the left side. r u saying that I could have a heart problem and is this something that already existed or something caused by the embolism. is there a possibility that these findings are related to lung cancer? here is the copy of the ekg

Answered by Dr. Drkaushal85 (23 minutes later)

Brief Answer:
Possibility of lung cancer is less likely.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Possibility of lung cancer is less likely.
Sorry to say but there is no ekg attached.
Please attach it in the attachment option.
And chronic left sided chest pain can be due to pulmonary embolism.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Drkaushal85 (1 hour later)

the results are attached

Answered by Dr. Drkaushal85 (15 minutes later)

Brief Answer:
I want ekg graph.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I have gone through the attachment you have provided.
I want to see the EKG graph.
This will be of more helpful.
How is your chest pain now?
Which drugs you are taking now?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Drkaushal85 (1 hour later)

chest pain is a constant aching feeling. I'm taking 10 of coumadin and my inr level was checked today and is good at a 2.0

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
You should quit smoking as soon as possible.

Detailed Answer:
Hi,
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Coumadin is good drug for maintenance of PE.
So continue with it.
What is the cause for your chest pain according to your treating doctor?
Have you undergone investigations for heart diseases like trop I, TMT?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Drkaushal85 (52 minutes later)

they haven't done any additional testing on my heart. they told me the chest pain was probably due to the embolism but it's been 2 weeks and the pain will not go away and isn't decreasing in severity. it feels the same as it did since they found the embolism on Sept 30. are these EKG results concerning to u? do they indicate heart disease

Answered by Dr. Drkaushal85 (20 minutes later)

Brief Answer:
No, they are not concerning but Trop I should be done.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Minimal ST depression is not a matter of much concern but Trop I should be done to rule out heart diseases.
Do you still smoke?
Is your pain more with movements?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Drkaushal85 (1 hour later)

still smome just a couple a day. waiting for nicotine patches to come in the mail. yes, the pain is worse withmovement and deep breathing. my heart rate is usually very high, well over 100 and resting heart rate is also over 100 sometimes. withball the information I have provided u with, do u have any opinion as to what is happening. I know u can't diagnos me, I would just like to know ur thoughts please. thank u so much

Answered by Dr. Drkaushal85 (8 hours later)

Brief Answer:
In my opinion, you should definitely get done Trop I levels.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
First of all, you should definitely stop smoking immediately.
How can smoke with PE?
In my opinion, you should definitely get done Trop I levels.
If this is normal then no need to worry for heart diseases for your chest pain.
But if they are elevated then further investigations to rule out heart diseases are needed.
Please tell me
1. Do you have breathlessness on exertion?
2. Do you have family history of heart diseases?
3. Are you obese?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Drkaushal85 (1 hour later)

I just checked my bloodwork results and it is showing a troponin t level of 0.01. what does that mean? yes, I have brethlessness on exertion, yes, there is history of heart disease in my family and no, I am not obese. I also noticed that there is a bilirubin total equal to 0.20. what do these numbers mean??

Answered by Dr. Drkaushal85 (1 minute later)

Brief Answer:
No need to worry for heart diseases as troponin is normal.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
No need to worry for ekg changes and heart diseases as your troponin level is normal.
Bilirubin is also normal.
So no need to worry for these numbers.
First quit smoking as soon as possible.
If you feel breathless even after 1 month then get done PFT (Pulmonary Function Test) to rule out bronchitis.
Please let me know if you had PFT done in the past or not.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Drkaushal85 (18 minutes later)

so what do u think is caisong the symptoms especially the tingling im getting . I am even feeling numbness in my face and lips that comes and goes and the tingling occured quite frequently today. what do u think

Answered by Dr. Drkaushal85 (4 hours later)

Brief Answer:
Possibility of either stress or vitamin B12 deficiency is more likely.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Possibility of vitamin B 12 deficiency is more likely.
So please let me know whether you have tested for vitamin B12 level or not.
Another possibility is stress and anxiety.
So also tell me if you are having stressful life or not.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Drkaushal85 (8 hours later)

b12 has been tested and is within normal range. I have been treated for anxiety and depression for years and have been taking medication to stabilize all that. I do not have a very stressful life. I have every-day stresses like everyone else but I honestly don't think the symptoms and results are due to things I am already being treated for. these symptoms are new and quite worrisome. and getting worse as the days go by. can u tell me if it's possible for something to be wrong neurologically that is causing my symptoms and a cat scan to appear normal? plz keep in mind that the scan was done WITHOUT contrast. is it medically possible for there to be something that won't pick up when it's done without contrast. my chest X-ray from the night I was admitted came back fine but when they did the carscan with contrast, they found the embomisms. I hope my question makes sense

Answered by Dr. Drkaushal85 (15 minutes later)

Brief Answer:
MRI is always better than CT scan for brain pathology.

Detailed Answer:
Thanks for your follow up question,
I can understand your concern.

CT scan of the brain is more informative only in head injury cases. Rest all pathologies are better seen on MRI.

So I am surprised why they didn't go for MRI for stroke symptoms.
And the contrast is a must for early ischemic changes in brain parenchyma.

Plain CT or MRI (without contrast) can be normal in the early ischemia.
CT scan does not have any significant role in stroke.

I will be happy to help you further.

Wish you good health.
Thanks

Above answer was peer-reviewed by : Dr. Arnab Banerjee