Medical Specialty >> Cardiology

Doctors Lounge - Cardiology Answers

Back to Cardiology Answers List

If you think you may have a medical emergency, call your doctor or 911 immediately. Doctors Lounge ( does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Site. 

DISCLAIMER: The information provided on is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician. Please read our 'Terms and Conditions of Use' carefully before using this site.

Date of last update: 10/20/2017.

Forum Name: Cardiology Symptoms

Question: Extracardiac shunt

 glenp - Mon Jul 21, 2008 2:50 am

I am 58 years old, have CFS, severe exhaustion and cognitive problems. I recently had an eko gram. Please tell me if these results would cause symptoms and if there is anything that I should be concerned about.

Following injection of agitated dextrose into the right arm, the right heart cavities become markedly echogenic. During spontaneous respiration <5 bubbles, and with cough <5 bubbles are identified in the left heart in a single fram consistent with a mild extracardiac shunt. No right to left shunt is identified with Valsalva maneuver.

A few contrast bubbles are noted late in the LV cavity. This is consistent with minimal intra-pulmonary shunting. Borderline abnormal study. No evidence of aortic coarctation. No significant ASD.

Thank you
 John Kenyon, CNA - Mon Sep 29, 2008 9:22 pm

User avatar Hello -

It seems as though the test uncovered a defect probably present since (or before) birth. Patent ductus is one defect often seen in a trio of defects known as tetralogy of fallot, but since there is "no significant ASD" (ASD: atrial septal defect, or hole between the left and right atria or upper chambers of the heart), then you probably don't have the tetralogy, just a mild ateriovenous malformation or fistula, an abonormal blood vessel connecting the heart and pulmonary vein (as a rule) which can cause some degree of loss of oxygenated blood. From the report you quote, it doesn't sound as though it would be enough to account for your symptoms, especially since at your age your heart and related anatomy has probably remodeled itself to accomodate the small abnormality. This sort of remodeling is often seen even in gross congenital heart defects, and while fairly vague midlife symptoms sometimes develop, the problems are usually well-tolerated by that time and are compatable with a normal lifespan.

I hope this is helfpful to you. It would seem you have a relatively minor defect. Your symptoms are probably more related to the diagnosis of CFS than to the shunt. Best of luck to you.
 glenp - Mon Oct 27, 2008 8:55 pm

Thank you so much for your help, much appreciated>

| Check a doctor's response to similar questions

Are you a Doctor, Pharmacist, PA or a Nurse?

Join the Doctors Lounge online medical community

  • Editorial activities: Publish, peer review, edit online articles.

  • Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.

Doctors Lounge Membership Application

Tools & Services: Follow DoctorsLounge on Twitter Follow us on Twitter | RSS News | Newsletter | Contact us