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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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ECG Showed Systolic Function Moderately Reduced, Mild Hypertrophy, Diagnosed AFib. Medication Or Surgery ?

My husband recently had echocardiogram that showed Left ventricle size as normal. Systolic function is moderately reduced. Ejection fraction app. 34-40% visually with mid to distal anterior wall hypokinesis & apical akinesis. Mild concentric left venticular hypertrophy. Grade 1 diatolic abnormality. He had 3 heart bypass surgery 15 yrs ago 7 has done extremely well until about 2 months ago when he was diagnoised with Afib. Should he make any changes w/medication or surgery?
posted on Mon, 19 Aug 2013
Twitter Tue, 20 Aug 2013 Answered on
Twitter Tue, 20 Aug 2013 Last reviewed on
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Cardiologist,  's  Response
Hi friend,
Welcome to Health Care Magic

     He needs further investigations –
     He needs TMT (Treadmill Exercise ECG) – with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
     If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this.
[CT angio is non-invasive study for the anatomy. If positive, she will need catheterisation, anyway.]
Discuss with your doctor

Take care     
Wishing speedy recovery
God bless
Good luck
_____________________________________________________________
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ECG Showed Systolic Function Moderately Reduced, Mild Hypertrophy, Diagnosed AFib. Medication Or Surgery ?

Hi friend, Welcome to Health Care Magic He needs further investigations – He needs TMT (Treadmill Exercise ECG) – with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle. If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this. [CT angio is non-invasive study for the anatomy. If positive, she will need catheterisation, anyway.] Discuss with your doctor Take care Wishing speedy recovery God bless Good luck _____________________________________________________________