Echocardiogram and Pulmonary Function Tests - May 2 2012

Jani and I got up at o'dark thirty to be at UCH for my 7 AM echocardiogram. After the test, we went upstairs to the 11th Floor Inpatient to visit Shawn Egle who is on her 4th VD-PACE. She looks great and we had a nice visit.

Then, we drove around Denver and found the house where we used to live in 1967-1968..oh, the memories. We had to pass time while my echocardiogram was read by the cardiologist so they could decided if I could have pulmonary function tests scheduled for 3 PM today. Pulmonary function tests can be dangerous if you have a blood clot in your heart.

From there we went to the Denver Museum of Natural History along with EVERY school child in Colorado on their class field trips. I wore my mask, but even then - I was leary of all those germs, I mean children.

 We took this picture (below) because it shows the critters that used to roam at my brother's house in north Texas.

While we were at the museum, the nurse practitioner called me to tell me that my echocardiogram was done and they felt like I could continue with the pulmonary function tests this afternoon. I still have the blood clot in the right atrium of my heart, but it is just 1 cm in size now.

CARD DX ECHO COMPLETE TTE TRANSTHORACIC STANDARD

Narrative

Study ID: 139649

Echocardiography Laboratory
Adult Echocardiography Report

Name: Malkiewicz, Judith A Study Date: 05/02/2012 07:18 AM BP: 118/67 mmHg
MRN: 535166 Patient Location: ECHO HR: 75
DOB: 12/08/1950 Gender: Female Height: 62 in
Age: 61 yrs Weight: 167 lb
Reason For Study: f/u assess for atrial clot BSA: 1.8 m2
Authorizing Physician: Myint, Han

Conclusions
Echodensity noted in superior aspect of RA most likely small thrombus on PICC line.
Previously measured approximately 2 cm, now is 1 cm in maximum dimension.
The left ventricle is normal in size.
Left ventricular systolic function is normal with no regional wall motion abnormalities.
The right ventricle is normal in structure and function.
No significant valve disease.

Procedure Summary
A complete two-dimensional transthoracic echocardiogram was performed (2D, M-mode,
Doppler and color flow Doppler).

Left Ventricle
The left ventricle is normal in size. There is normal left ventricular wall thickness.
Left ventricular systolic function is normal with no regional wall motion abnormalities.

Right Ventricle
The right ventricle is normal in structure and function.

Atria
The left atrium is normal size. The right atrium is normal. Echodensity noted in
superior aspect of RA most likely small thrombus on PICC line. Previously measured
approximately 2 cm, now is 1 cm in maximum dimension.

Mitral Valve
The mitral valve is not well visualized but is grossly normal. There is trace mitral
regurgitation.

Tricuspid Valve
The tricuspid valve is not well visualized, but is grossly normal. There is mild
tricuspid regurgitation. Right ventricular systolic pressure is normal.

Aortic Valve
The aortic valve is not well visualized, but is grossly normal. There is no aortic
stenosis. No aortic regurgitation is present.

Pulmonic Valve
The pulmonic valve is not well visualized. There is no pulmonic valvular stenosis. There
is no pulmonic valvular regurgitation.

Great Vessels
The aortic root is normal. The pulmonary artery is not well visualized. The inferior
vena cava is normal in size with respiratory collapse, indicating a right atrial
pressure of approximately 3 mmHg.

Pericardium
There is no pericardial effusion.

MMode/2D Measurements and Calculations
IVSd: 0.76 cm LVIDd: 3.8 cm FS: 47.1 % RVDd minor: 2.3 cm
LVIDs: 2.0 cm
LVPWd: 0.90 cm
_______________________________________________________________________

Ao root diam: asc Aorta Diam: 2.6 cm EDV(MOD-sp4): 53.9 ml EDV(MOD-sp2):
2.5 cm ESV(MOD-sp4): 21.3 ml 47.4 ml
EF(MOD-sp4): 60.5 % ESV(MOD-sp2):
14.9 ml
EF(MOD-sp2):
68.5 %
_______________________________________________________________________
LAV(MOD-sp4): 45.8 ml EDV index(MOD-bp): RVDd base: 3.3 cm
EDV(MOD-bp): LAV(MOD-sp2): 20.4 ml
51.6 ml LAV(MOD-bp): 31.3 ml 29.1 ml/m2
ESV(MOD-bp): LAV(MOD-bp) index:
18.4 ml
EF(MOD-bp): 17.6 ml/m2
64.4 %

Doppler Measurements and Calculations
MV E max vel: MV dec time: Ao V2 max: LV V1 max PG: 3.6 mmHg
77.0 cm/sec 0.24 sec 145.2 cm/sec LV V1 max: 94.8 cm/sec
MV A max vel: Ao max PG: 8.4 mmHg
77.0 cm/sec
MV E/A: 1.0
_______________________________________________________________________
PA V2 max: TR max PG: RAP systole: Aortic Valve Velocity Ratio:
93.7 cm/sec 22.1 mmHg 3.0 mmHg 0.65
PA max PG: 3.5 mmHg RVSP(TR):
25.1 mmHg

_________________________________________________________________________________________

Reviewed and Interpreted By: Amber Khanna, MD on 05/02/2012 08:52 AM
Sonographers: Theberge, Marc, RDCS

Component Results

There is no component information for this result.

General Information

Collected:

5/2/2012 7:18 AM

Resulted:

5/2/2012 8:51 AM

We went back to UCH about 1 1/2 hours early for my pulmonary function tests and they took me early which was nice. The technician, Kathy, was very nice and the test took almost an hour. Although, I did okay, my lung performance was not stellar. 

Pulm dx Full PFT

Impression

Pulmonary Function Testing Interpretation Guide

Test Quality: Acceptable test results.
Airflows: Airflows within normal limits (FEV1 >= to 80% of
Predicted).
Lung Volumes: Lung volumes are within normal limits (80% <= TLC
=< 120%) (RV <= 140% of Predicted).
DLCO: THE DLCO and DLCO/VA are decreased: Moderate. The DLCO is
decreased out of proportion to the lung functions. Consider
pulmonary vascular disease.
Airway Resistance: Raw: Increased sGaw: Decreased

6 Minute walk: Significant desaturation with ambulation. 
(I wore a pulse ox during the walk and my heart rate was 126 
the whole time with an oxygen level of 95 percent - so, 
I don't know where they came up the "desaturation" comment)

James C Lavelle IV, MD

Component Results

There is no component information for this result.

General Information

Resulted:

5/2/2012

Ordered By:

MYINT,HAN, MBBS

I had to have the echocardiogram and pulmonary function tests to qualify for the 2nd autologous stem cell transplant.

Exhausted, I slept in the back of Bart and Jani drove me back to Greeley, Colorado. What a terrific sister to waste and entire day with me!