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MRI findings in ARVD for NSVT and block in arteries.

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I have had Idiopathic RVOT NSVT for over a decade and recently had an RF ablation done and has controlled my Ectopic/NSVT episodes. I still have ectopic beats but less than 2-3 a minute, before RF ablation I had 40K beats a day.

I am on Verapamil Extended release 120MG two times a day and Atorvastatin once a day.

I have some shoulder pain and mild chest discomfort and is not related to Exertion and doesnt look like cardiac problem either. I have it even in night and even my pulse looks ok. I was asypmtomatic when I had 40K PVCs a day and with only less than 5% beats it may not be the reason for my shoulder and mild chest discomfort.

I had MRI done few days back to rule out ARVD as a cause for my NSVT and it came back ok as no evidence for ARVD was found.

Can you look in to the MRI report and advise if it also has looked in to any ischemic factors and any blocks in the artery and the chest discomfort that I have now could be because of Angina? or MRI has not looked in to blocks in my heart and I should have a TMT or Angiogram, MRI is less than month old.

Category: Cardiologist

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Dr. Vivek Mahajan
Category: Cardiologist
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 32 Doctors Online

Expert:  Dr. Vivek Mahajan
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Hello.
Thank you for your query at DoctorSpring.com.

You had a successful RVOT VT ablation by 3D mapping and now you have atypical chest pain.
Your echo is normal. Your MRI doesn't mention about the coronary arteries. Anyways MRI isn't the best test to look for coronary arteries.

You are 32 years old patientof age. So you have a low probability of having coronary artery disease. In view of the ongoing atypical chest pain, you may undergo a TMT just to rule out the small possibility of a coronary artery obstruction causing these symptoms. Other causes of chest pain like musculoskeletal or lung causes or even anxiety have to be thought of. You have to also get a chest X-Ray to rule out any other cause of chest pain.
I hope this was helpful. Feel free to discuss further.


Regards,
Dr Vivek Mahajan,
DM Cardiology.


Patient replied :

Thanks doctor, I had followup with my cardiologist here today as I learnt from you that MRI was not conclusive on the coronary arteries part.
Since the pain was not related to exertion, and I have been feeling for few days now on very much a consistent basis, the doctor felt this is not related to Angina and TMT is not required.
But since the pain is just after few days of Ablation, doctor did do a echo test and ECG today, echo was normal and ECG was normal except for PVCs in couplets and Triplets. Even after Ablation I have these some times and definetly not as frequent as before ablation.
WIth normal MRI, repeatede Echo, Normal ECG my doctor feels the pain is not related to heart could only be muscle or gastric.
For the Idiopathic RVOT NSVT, doctor feels a repeated ablation might be required in future, and is no hurry as it is idiopathic and I am asymptomatic. I am on Celaptin 120 SR two times a day.


Expert:  Dr. Vivek Mahajan
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Hello. Yes. It is atypical pain as we had already observed. Most likely musculoskeletal. A TMT is not must. It would only have a reassuring effect on you if it were negative and would have clarified your doubts. Anyways your doctor is absolutely correct it is not a must do test.
All the best and hope you do not require a re-ablation.
Regards, Dr Vivek Mahajan.

Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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