62-year-old female with systolic heart murmur for 6 years. Her first echocardiogram showed mild to moderate LV dysfunction with regional wall motion abnormality. The second echocardiogram the left ventricular function was interpreted as normal, there was left ventricular hypertrophy and severe aortic stenosis. The expert recommends to perform another third echocardiogram. If the patient has truly left ventricular function and severs aortic stenosis then aortic valve replacement surgery is recommended, even if she is asymptomatic.
A very physically active 49-year-old male with a history of labile hypertension and hypercholesterolemia with an LDL cholesterol of 126 mg%. He underwent an exercise stress test which revealed reversible inferoseptal ischemia at a peak heart rate of 171 bpm and peak blood pressure of 195/85. In the expert's opinion, the results suggest that the patient has silent myocardial ischemia and may be at risk for sudden cardiac death, especially in light of the marked exertional level of activity.
54-year-old obese male with end stage renal disease due to membranous nephropathy, has received 2 renal transplants in the past and is highly sensitized. He underwent coronary angiography for vessel CAD, and PTCAs and stanting were performed. His current treatment consists of multiple medications including mycophylate according to the instructions of his transplant nephrologist. His cardiologists sees no contraindication to transplantation.