Heart at 54%? What does this mean - text from doctors shown.

[Snooks1971]

Hi all,
My Dad had bloods and a chest X-ray last week because of a slight shortness of breath. He is 84, ex-builder and fit and active. Takes no medication, blood pressure is good.
This is the message from the GP below. What does it mean? An enlarged heart?
There was another message from the GP requesting to see him next Monday.
Any ideas please?

Sorry struggling to attach photo!

Was it the exact wording? Does he have heart failure?

Hopefully attached

@Dreichweather sorry I struggled to attach - my bloody iPad storage was full and I couldn’t synch the photo! It’s attached now.. I might as well just typed it out so I will do now.

Oh it’s there.

It means his heart is ever so slightly bigger and this as long with his bloods could suggest heart failure but they need to do more tests to find out what’s happening.

Lots of people live many years or even a decade or more with heart failure.

That is a poorly worded message. I think you'll have to ask the Dr for clarification.

I think it means that the heart shouldn’t take up more than 50% of the xray and his is taking up 54% a sign that it’s ‘grown’ but not necessarily in a good way, combined with markers of heart failure. Heart failure is very treatable for quite a while now, many people live for many years in even a fairly serious stage. Try not to worry - the scan will give more information.

Thank you everyone.
Thank you for the reassurances too.

@SolidarityCone that explanation makes sense, I googled it (before he forwarded me the text message) and as usual, Google was a bit…vague.

@Tulipvase I agree! I did crop the message to not include the GP name at the bottom, but from the name I think that English may possibly not be his first language. However my Dad gets on really well with him in person, the GP is caring and very pro active.

i’m sorry but no doctor wrote that. if they did they need to go back to medical school.

I work in a GP surgery and this text would never have been sent where I work.
It raises more questions than it gives answers and is causing panic.
The GP should have booked in an appointment to discuss findings and next steps.

It makes perfect 'medical' sense - normally the heart shadow takes up 50% of the width of a chest x-ray when it's taken from back to front. 54% is a bit bigger than usual but nothing completely terrible. The blood marker is probably BNP and that may be raised if there's a degree of heart failure. Heart failure can cause shortness of breath (but so can a billion other things aged 84!). The scan will almost certainly be an echo which looks at the heart dimensions in much more detail than an x-ray can and will give an idea of function (which is the most important thing). The x-ray would also mention if there was florid signs of heart failure (as well as it being pretty obvious usually on examination during an appointment). Sounds like the GP's properly on the case and doing the right thing. Txt message isn't the ideal medium for explaining cardiac physiology, but appointments seem to be universally scarce (and the outcome of an appointment would have been the same.... he needs an echo so they can decide if any treatment's needed).

@Greybeardy thank you so much! He’s not had any shortness of breath since his X-ray/bloods. He only went to the GP because he had suffered a D&V episode for a few days and took 2 weeks to regain his appetite. GP is excellent and undertook a full MOT…

@basketballcricketball @hangingonfordearlife1 I totally agree with you both! It’s a GP practice in the depths of rural Lincolnshire x

Sorry again @Greybeardy what is BNP please?

Brain natriuretic peptide - it can be a marker of a heart that's struggling, but equally it can be raised by other things (including increased age), and doesn't necessarily mean anything terrible (d&v in an old person could conceivably give a slightly raised BNP without there being anything really to worry about). If it's never been tested before (which it probably won't have been if he's usually pretty fit), there's nothing to compare this result with to know if it's normal for him or a bit on the wonk. An echo should give a clearer idea about the heart function and whether it's normal for someone of his age (remember that most 'normal' ranges are for younger folk so it takes a bit more thought to know if things are normal for the actual person in front of you).

(clearly the above is all in very general terms, extrapolating from a screenshot and not much clinical info...the GP's in a much better position to explain it all once the scan's done).

no it doesn’t, doctor wouldn’t use words like big or bigger. Maybe enlarged or slightly enlarged. chemicals in blood? no way would a medical professional use that term. it’s poor english and poor medical terminology. given the fact 80% of the world studies medicine in english this is just not making sense to me. He would’ve also had to pass an equalisation exam in english

I am a doctor and I frequently use words like 'big' and 'bigger'. Most of us don't talk like characters in a Dickens novel!

Please, please, let us not descend into a typical MN thread that derails from the OP. It’s so bloody typical these days sadly.
I’m very grateful for all the responses, I was just after a bit of clarity and hopefully reassurances.

Doctors, when talking to layman, will use layman’s terminology. Although you do get a small element of medics and clinicians, normally those who define their entire selves by their profession, who enjoy setting themselves apart, even from the patients in question, by throwing around highly medicalised language, which can be largely impenetrable.

that’s completely fine but this doesn’t even make grammatical or contextual sense. my whole family work in medicine it’s just something that should not have been sent. Any contact with patient should be clear and probably ask for an appointment

It's worth remembering that an X-Ray is, sort of, a shadow so can show things as larger.

The Dr is probably going to send your dad for an echo, this is an ultrasound of the heart and it can take incredibly accurate measurements of the heart chambers, valves and ejection fraction (the amount of blood that is expelled in a heart beat).

I agree but surely you would explain 50/54% of what at least?

OP I hope your dad is feeling better.

Heart failure always sounds so dramatic, as though your heart is going to pack up on the spot. Even if this is what he has there are degrees of it and people live for years and years with drugs to help the heart along. It sounds as though the right things are being done and hopefully the picture will be clearer soon and the right treatment can be started.