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What Does My MRI Scan Report Indicate?
Question: Follow up with Dr. RIshu Saxena from Linnea Epstein
YYYY@YYYY
I am following up with my original question w same Cardiologist re my 28 year old son whose grandmother had HOCM?
Prefer same cardiologist, Dr. Saxena, please.
Son has visited cardiologist. Has a 7 day holster strip attached to chest. This Tuesday Ihle has an appt with the cardiologist who will, according to test results schedule either an MRI or an echocardiogram for him. He continues to be dizzy chronically.
With HOCM or enlarged heart is in family (grandmother) why not do an echo ASAP to rule out genetic association risks?
Yes, I agree. An ENT and Neurologist should be consulted perhaps sooner than later. WHat do you think?
YYYY@YYYY
I am following up with my original question w same Cardiologist re my 28 year old son whose grandmother had HOCM?
Prefer same cardiologist, Dr. Saxena, please.
Son has visited cardiologist. Has a 7 day holster strip attached to chest. This Tuesday Ihle has an appt with the cardiologist who will, according to test results schedule either an MRI or an echocardiogram for him. He continues to be dizzy chronically.
With HOCM or enlarged heart is in family (grandmother) why not do an echo ASAP to rule out genetic association risks?
Yes, I agree. An ENT and Neurologist should be consulted perhaps sooner than later. WHat do you think?
Brief Answer:
2d echo should be done to rule out HOCM.
Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic again,
2D echo as told earlier is gold standard test to diagnose HOCM.Irregular septal hypertrophy is seen which is diagnostic of HOCM.
MRI cardiac is usually done to rule out cardiac cancers and Amyloidosis can be done to rule out HOCM but is rarely used.
In a patient presenting with chronic dizziness with family history HOCM.
Protocol should be like-
1)2d echo -If normal go for Carotid doppler to rule out if blood supply to brain is normal.
If both these tests are normal then dizziness is either Central(Brain related) or peripheral(Ear related).
MRI brain should be done to rule out Central cause while Caloric test and inner ear investigations should be done to rule out peripheral cause.
Though not asked yet patient with cardiac problem usually present with syncope or presyncope and not with chronic dizziness and vertigo.
Regards.
2d echo should be done to rule out HOCM.
Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic again,
2D echo as told earlier is gold standard test to diagnose HOCM.Irregular septal hypertrophy is seen which is diagnostic of HOCM.
MRI cardiac is usually done to rule out cardiac cancers and Amyloidosis can be done to rule out HOCM but is rarely used.
In a patient presenting with chronic dizziness with family history HOCM.
Protocol should be like-
1)2d echo -If normal go for Carotid doppler to rule out if blood supply to brain is normal.
If both these tests are normal then dizziness is either Central(Brain related) or peripheral(Ear related).
MRI brain should be done to rule out Central cause while Caloric test and inner ear investigations should be done to rule out peripheral cause.
Though not asked yet patient with cardiac problem usually present with syncope or presyncope and not with chronic dizziness and vertigo.
Regards.
Above answer was peer-reviewed by :
Dr. Kampana
Thank you for diagnostic info once again.
I don't understand why this Cardiologist here in XXXXXXX is doing the holder test wo the echo for 7 days.
In my mind, the info re genetic discovery for familial HOCM is 25% and he is doing a very conservative approach which is less costly but ultimately an echo is needed to rule out HOCM due to heritary..?
My son has given me permission to address his physician so I'm going to ask him
why there was no immediate echo and WHY is an MRI scheduled prior to an echo?
Even as a layman I can see some "odd order of progression" here.
If you have suggestions as to how to deal with this cardiologist wo offending him kindly advise.
I appreciate you so much. Thank you, Dr. Saxena
I don't understand why this Cardiologist here in XXXXXXX is doing the holder test wo the echo for 7 days.
In my mind, the info re genetic discovery for familial HOCM is 25% and he is doing a very conservative approach which is less costly but ultimately an echo is needed to rule out HOCM due to heritary..?
My son has given me permission to address his physician so I'm going to ask him
why there was no immediate echo and WHY is an MRI scheduled prior to an echo?
Even as a layman I can see some "odd order of progression" here.
If you have suggestions as to how to deal with this cardiologist wo offending him kindly advise.
I appreciate you so much. Thank you, Dr. Saxena
Brief Answer:
follow up answer.
Detailed Answer:
Hello again,
As per you query Your patient is young and is having recurrent dizziness with palpitations.Cardiologist is doing holter to rule out possibility of dizziness due to irregular heart beat clinically termed as arrhythmia.There are various types of ventricular and atrial arrhythmia which can cause dizziness.As patient had history of palpitations holter is ok and should be done.
As per as HOCM is concerned Doctor should go for 2d echo Asap,It's a 10 minute test and will make clear whether your son has HOCM or not.
Why MRI is scheduled prior to Echo and Stress test is something i can't understand,I would suggest you to ask your cardiologist directly what is he suspecting?
MRI is not investigation of choice when it comes to heart.
Protocol should be to do do a echo,Holter and stress test first.
Doing MRI of heart before echo and stress test is definitely "odd order of progression".
You can just ask your cardiologist what is he suspecting and why does he want a MRI before 2D echo or TMT, I don't think he would feel offended.Patient has all rights to know why a particular test is performed on him.
It may be possible that he is suspecting something which we are missing.So it's a good idea to ask him directly.
Thanks.
follow up answer.
Detailed Answer:
Hello again,
As per you query Your patient is young and is having recurrent dizziness with palpitations.Cardiologist is doing holter to rule out possibility of dizziness due to irregular heart beat clinically termed as arrhythmia.There are various types of ventricular and atrial arrhythmia which can cause dizziness.As patient had history of palpitations holter is ok and should be done.
As per as HOCM is concerned Doctor should go for 2d echo Asap,It's a 10 minute test and will make clear whether your son has HOCM or not.
Why MRI is scheduled prior to Echo and Stress test is something i can't understand,I would suggest you to ask your cardiologist directly what is he suspecting?
MRI is not investigation of choice when it comes to heart.
Protocol should be to do do a echo,Holter and stress test first.
Doing MRI of heart before echo and stress test is definitely "odd order of progression".
You can just ask your cardiologist what is he suspecting and why does he want a MRI before 2D echo or TMT, I don't think he would feel offended.Patient has all rights to know why a particular test is performed on him.
It may be possible that he is suspecting something which we are missing.So it's a good idea to ask him directly.
Thanks.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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