Riley,'
 
it sounds like typical radiology garble. :)
 

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Date: Wed, 28 Jul 2010 19:35:21 -0700
From: [log in to unmask]
Subject: Re: 6 mo old
To: [log in to unmask]

I would like to know more about an pediatric echocardiogram on this infant, and if possible get some of her liver blood levels. At six months old. Blood levels are always a concern. Additionally what is her SPO2 status when all of this is going on. What does the radiologist mean normal findings, " Doppler waveforms are normal throughout with the exception of lack of normal diastolic flow within the right iliac, femoral, and popliteal arteries throughout the exam, and intermittent lack of diastolic flow within these vessels on the left. The size of the vessels appears normal with the exception of the left iliac artery which appears relatively diminutive."  WHAT?? Really does sound a like a blood volume/cell production issue to me...maybe. Interesting

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From: JASON r <[log in to unmask]>
To: [log in to unmask]
Sent: Wed, July 28, 2010 6:17:04 PM
Subject: Re: 6 mo old


KTS is some what of a stretch.. It does not present with blue feet while standing, then resolves while lying, maybe secondary effects of multiple av's but would think it would be constant. I have seen this (bluing) phenomenon in many patients. Dont know what it is, even after venography, and angio.. however it was present in two patients with vasospastic disease, and even one with burgers.

I like the Coartaction, or evern Sup vena cava syndrome ???  maybe


good luck sound interesting.

Hope this helps.
> Date: Wed, 28 Jul 2010 06:45:03 -0700
> From: [log in to unmask]
> Subject: Re: 6 mo old
> To: [log in to unmask]
>
> KTS is typically one sided and the discoloration does not go away with elevation. This sounds like the patient has Bilateral lower extremity
> "discoloration" just when standing? Am I correct in your explanation?
> It there redness or blue discoloration? Did you do pressures and PPG on the toes? Still a lot of questions--does the patient's limb measure symmetrically, how is their gait and development? I measure the length of the feet also.
> L
>
> -----Original Message-----
> From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Connie McCoy
> Sent: Tuesday, July 27, 2010 8:01 AM
> To: [log in to unmask]
> Subject: 6 mo old
>
> Dear FlowNetters,
> Your opinions/comments are appreciated regarding a 6 mo old female with discoloration of BLE in the upright position. The pt apparently had a BLE arterial duplex scan. My initial thought was May Thurner Syndrome or some ileo/caval abnormality.
> Here are the findings by a radiologist:
> FINDINGS:
> Flow was documented within all of the interrogated vascular structures. No intraluminal thrombus is identified throughout. Complete coaptation occurred with graded compression of the venous structures of the lower extremities. Doppler waveforms are normal throughout with the exception of lack of normal diastolic flow within the right iliac, femoral, and popliteal arteries throughout the
> exam, and intermittent lack of diastolic flow within these vessels on the left. The size of the vessels appears normal with the exception of the left iliac artery which appears relatively diminutive.
> Connie McCoy, RVT
>
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