Preliminary Stress Echo Results

[KimC]

Hi,

I called for my stress echo results finally. (I put this off; the test was performed the week after my son's birth in late July, and I was afraid of the results).

I don't have the tech details yet, only the cardio's interpretation. I see him again in a couple of weeks -- any questions you could suggest I ask would be welcome.

Would someone please help me understand the significance of the results?

-- No ischemia or evidence of CAD.

-- Mildly dilated left ventricle, but normal systolic function and no hypertrophy.

-- Sinus bradycardia

Given my age, physical fitness level and low-weight, the low BP probably isn't a problem. But this and the dilated LV could explain why my BP kept dropping during Labor ...? Questions for the cardio!

Does a mildly dilated LV mean I have mild heart failure, even if the systolic function is normal? I'm confused on how to gauge its signficance. When are you diagnosed with heart failure, when systolic function fails or there's evidence of hypertrophy? Is it diagnosed when the heart starts or stops compenstating?

Can a dilated ventricle reverse itself, or does this mean that surgery is weeks, months or years away? Is there any way to calculate the timeframe for someone with valvular insufficiency and a mildly dilated LV?

Finally, is a dilated LV considered normal, in other words, is this simply a sign of aging and therefore not a sign of disease?
I don't know the gradient of valve insufficiency yet; I'm afraid to ask.

Thanks for your help.

 

[Ross]

Umm I think I'll let someone else address this one. You really want meat and potatos don't ya?

 

[ccrawford]

Kim - You really need to talk to your doc and start getting used to digging out the answers - that's what he's there for. I'll try to answer your questions in the meantime. You have no ischemia, meaning that there was no observed damage to the heart from lack of oxygen such as would be caused from a blocked coronary. You have a mildly dilated left vent meaning that the heart has been working harder than it should and the heart muscles have gotten thicker from that overwork-presumably from a bad valve. Yes the muscle can reverse itself in time, once the root cause has been resolved. The key phrase is "mildly dilated"-not a huge problem kiddo. Hypertrophy occurs when the muscle builds up so thick that it impedes the flow of blood to/from the heart and you do not have this problem. Your heart beat is slow, but your heart is beating correctly from an electical control perspective. The real issue, and the one that will determine what course of action and how soon is "what is causing this problem"? My guess, and thats all it is, would be a valve problem. Take all of this one piece at a time, Kim. When you are first finding out these answers, its pretty scary and most of us have been there before. I could only stand to read the VR.com screens for a few minutes at first, then it started to get easier. We are all here to help answer your questions, and to help you get more comfortable with all of the stuff you are facing. Just about every one of us was scared at first, but slowly but surely, we got some help, and we started getting smarter about this stuff and a whole lot calmer. Beleive me when I say someone will be here to try to answer your questions. When you talk to your cardio, focus on what he says about the valve. Diameter of valves, ejection fraction, degree of stenosis, degree of regurgitation. OK - Starting to feel better ?? Chris

 

[KimC]

OK. You're making me cry, though ... thank you for your kindness and compassion. It figures you're a Hoosier, they're cut from the best cloth. No offense to the rest. It's just a fact, (and has nothing to do with that I grew up there).

I will try not to be afraid, but I have never thought about my own health, much less my own heart and mortality. Even though I'm a Christian, it scares and hurts me to think that my children may not have me around as long as they would need me. In fact, this thought hurts me the most, although I would never tell my husband this. Geez, I'm probably overreacting. I know, I know -- I'll probably be run over by a truck instead of dying from a heart problem.

I just hated to hear that anything had "progressed" since my last echo, frankly. I was enjoying the freedom from worry, and really didn't want to see my cardio's ugly mug for another year.

God bless,

 

[Ross]

Kim your going to be fine, really. Of course your scared, not one of us that's been through this hasn't been. You've got a couple of things going for you that alot of us don't or didn't have and the biggest one I see is, that things are being caught early before any real damage is done. Don't be afraid to ask about the severity of the regurgitation. It's a need to know type of thing. Grab the bull by the horns and drag that thing around the ring until your satisfied with ALL of the answers to your questions.

Another thing if I may be so bold, Share your true feelings with your husband. He needs to know them as much as you need him to be there for you. Just having the piece of mind that everyone is on the same page and all is known will make a big difference in how you feel mentally.

 

[KimC]

Thanks, Ross. I'm trying to be honest w/ my spouse, but he's in denial about all of this. He jokes about it, in fact. I know that sounds cold, but he's not at all versed in medical matters and finds it impossible to accept that someone my age could be facing heart surgery in a few years. Who knows, maybe a healthy dose of denial would be good for me, too.

The bottom line is that I feel differently than I did a year ago -- breathing pressure, fatigue and a much stronger heartbeat. The echo report at least confirmed that something's not quite right. I don't complain often, so to my family, I seem the same.

I hate to whine, but I guess I feel misunderstood. That's probably why I'm reaching out to people who CAN understand what I'm going through, even if I'm only in the early stages.

And you guys are right, I'm in pretty good shape! I think meeting w/ my cardio, having more detailed answers and some semblance of what to expect will be enormously reassuring.

I'll be sure to share the results, and look forward to your continued insights and friendship.

THANK YOU!

 

[bvdr]

Hi KIm,

I kinda know what you are going through. My husband never wants to talk about my heart problems either. It isn't that he doesn't care but he hates all things medical and finds it very hard to even think of this mess. We have been a twosome since before we were teenagers and married on his 19th birthday. We are best friends and this is just hard on him. But sometimes I do need to talk and that is one of the reasons that this board has been so important to me. Here I am able to vent, learn, share, and enjoy everyone else's company.

I hope your husband will soon join you at the hip with this but if he doesn't, we are here for you too.

Don't guage your need for intervention by your symptoms. I hope you have an agressive doctor in your corner watching out for your long term interests. I pray for the very best for you and am following your progress. Remember, for many of us the waiting is the hardest part.

 

[KimC]

Thank you, Betty from the bottom of my (leaky) heart! I appreciate your kind words of support and will share my discussion w/ my cardio in a couple of weeks.

 

[ALCapshaw2]

Kim,

ONE suggestion:

Drag your husband (kicking and screaming if necessary) to your next appointment with the Cardiologist so he can get the word 'straight from the horses mouth'. This way, he won't be able to suggest that you are 'making a mountain out of a mole hill'.

Valve disease can strike at ANY age whereas Coronary Artery disease typically progresses with age, but even that is found to be starting in the 20's and many patients have had heart attacks in their 40's.

FWIW, medical adjectives seem to progress from No/None to
Trace to Mild to Moderate to Severe and perhaps one more. Mild or less is generally not of great concern. Moderate usually indicate a need to monitor the situation for changes.
(These are MY personal impressions. You may want to verify those opinions.)

'AL'

 

[LUVMyBirman]

"he's in denial"

I am embarssed to be posting this..Here it goes. Boy do those words sound familiar Kim! My husband asked the surgeon twice, on two different occasions if I "really required the surgery" His disbelief even continued beyond the surgery. I had complications and would have gotten to the hospital sooner...he kept telling me I was ok. Don't get me wrong he's a wonderful man, husband, father. I think his way of dealing with it was pure denial. He quickly learned you can run, but not hide. Having something equally as earthshaking happen to him personally heath wise was another eye opener.

Don't worry, I am sure your husband will find his own way to deal with and come to an understanding and comfort level. In the meantime, we are all here for you!
Take care,

 

[KimC]

Thanks, Al and Gina. I will drag my dearly beloved husband by his boot heels -- Teva straps in his case -- to my next cardio appointment.

And I can't wait to see the look on his face when the doctor says, "No, AI and a dilated LV are not a normal part of aging, especially for a 36 year old."

I don't know if the Mitral and Tricuspid leaks have progressed, but was told that the AI leak had. I'll find out to what degree.

How weird is it that I actually know the names and acronyms for heart ailments? Surely this is a nightmare that I will wake up from.

God bless y'all,

 

[Ross]

How weird is it that I actually know the names and acronyms for heart ailments?

It's not weird and when shared with a physician, it puts him in a position of realizing that the patient is a bit educated. Just be sure that if you don't understand something he/she says, don't leave the office until you do. We can help educate to a degree, but there is still much more you'll need to know and only they can provide those answers.