Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Does My CT Angiogram Suggest?
Question: Hi,
I had massive saddle PE's 10 years ago then diagnosed with antiphospholipid antibody syndrome and 6 years later, SLE.
I just had an echocardiogram last week ordered by my pulmonary doctor because he suspects PH. I also had a VQ scan which was normal.
My greatest concern is that my last 2 echo's showed an "echodensity noted at bifurcation of pulmonary artery. I also had one last April and it showed the same thing but it was 1.7cm. They thought it was a PE sent me for a CT angiogram which was negative for PE. Now this "thing" is 3 cm. I don't have a follow up until 11/11 with pulmanologist. I should hope he would have called me if he felt it was an emergency. It also states that there is abnormal tissue Doppler imaging consistent with diastolic dysfunction of the LV. I am concerned as to the origin of the 3cm echodensity. Thank you, XXXXXXX
I had massive saddle PE's 10 years ago then diagnosed with antiphospholipid antibody syndrome and 6 years later, SLE.
I just had an echocardiogram last week ordered by my pulmonary doctor because he suspects PH. I also had a VQ scan which was normal.
My greatest concern is that my last 2 echo's showed an "echodensity noted at bifurcation of pulmonary artery. I also had one last April and it showed the same thing but it was 1.7cm. They thought it was a PE sent me for a CT angiogram which was negative for PE. Now this "thing" is 3 cm. I don't have a follow up until 11/11 with pulmanologist. I should hope he would have called me if he felt it was an emergency. It also states that there is abnormal tissue Doppler imaging consistent with diastolic dysfunction of the LV. I am concerned as to the origin of the 3cm echodensity. Thank you, XXXXXXX
Brief Answer:
it could be pulmonary hypertension
Detailed Answer:
Hi,
Thank you for contacting HCM. Since the echodensity has been evaluated for pulmonary embolus through CT angiogram and Ventilation perfusion ratio which turned out to be normal, that safely excludes pulmonary embolism. The next thing in line is pulmonary hypertension which may be the cause of increase echogenicity on echocardiogram. Also if its pulmonary hypertension, there is a way on doppler echocardiogram that they can calculate the approximate pulmonary artery pressure which you should ask for if they haven't already done it. If that is suggestive, you may be having pulmonary hypertension which typically manifests with shortness of breath especially with exertion. If the results on echocardiogram as for regards of pulmonary hypertension are doubtful, you may undergo right heart catheterization for definitive diagnosis. Pulmonary hypertension may be seen with prior history of pulmonary embolism given again with your history of systemic lupus erythematosus. Please consult a pulmonary hypertension specialist on this matter for further details. Thank you
Dr. Khan
it could be pulmonary hypertension
Detailed Answer:
Hi,
Thank you for contacting HCM. Since the echodensity has been evaluated for pulmonary embolus through CT angiogram and Ventilation perfusion ratio which turned out to be normal, that safely excludes pulmonary embolism. The next thing in line is pulmonary hypertension which may be the cause of increase echogenicity on echocardiogram. Also if its pulmonary hypertension, there is a way on doppler echocardiogram that they can calculate the approximate pulmonary artery pressure which you should ask for if they haven't already done it. If that is suggestive, you may be having pulmonary hypertension which typically manifests with shortness of breath especially with exertion. If the results on echocardiogram as for regards of pulmonary hypertension are doubtful, you may undergo right heart catheterization for definitive diagnosis. Pulmonary hypertension may be seen with prior history of pulmonary embolism given again with your history of systemic lupus erythematosus. Please consult a pulmonary hypertension specialist on this matter for further details. Thank you
Dr. Khan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you, Dr. XXXXXXX I was told a previous echocardiogram in 2011 revealed PH however, the doctor I was dealing with at the time, never told me! My RVSP was estimated at 25 mm Hg on the echo from last week. The pulmonary doctor told me it can be higher at times but from what I have read, 25 is not considered high. He did mention right heart XXXXXXX but wanted to do the echo since it had been 6 months from the last one.
Thanks again,
Thanks again,
Brief Answer:
you may still be a candidate for right heart XXXXXXX
Detailed Answer:
Hi,
I will tell you this, if there is very high clinical suspicion of pulomonary hypertension for that you must have the classic dyspnea, even though the pressure calculated on echo may be normal, you may still be a candidate for right heart catheterisation. Do discuss this option with your specialist. Hope it helps.
Dr. Khan
you may still be a candidate for right heart XXXXXXX
Detailed Answer:
Hi,
I will tell you this, if there is very high clinical suspicion of pulomonary hypertension for that you must have the classic dyspnea, even though the pressure calculated on echo may be normal, you may still be a candidate for right heart catheterisation. Do discuss this option with your specialist. Hope it helps.
Dr. Khan
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
