echocardiogram showed possible weak heart muscle - am panicking a bit

[lirael]

Had an ECG and echocardiogram (ultrasound) today as part of a routine checkup for my prolapsed mitral valve. Have had MVP my whole life but have never had any treatment, so was expecting this to be nothing to worry about. However the consultant said that the ECG showed that my heartbeat was
" all over the place" and the echo had identified a possible weakness in the heart muscle. He did say that the echo results may have been affected by the ectopic beats, and that they would repeat it once they've got my heart rate under control. I have come home with a 24 hour ECG machine strapped to my chest, which will then be analysed. Depending on what this shows, I'll be prescribed medication to regulate the heart and then the echo will be repeated. He said my mitral valve looked pretty strong and he didn't think the ectopic beats were originating from there. He described it all as 'odd'

I have always had loads of ectopic beats and have had a number of ECGs over the years, though none in the last 10 (I'm 52). Cardiologists have always put it down to the MVP. Anyone had experience of an irregular heartbeat affecting echo results or a diagnosis of a weak heart muscle? Have been googling cardiomyopathy and scaring myself silly . have had a bit of dizziness and fatigue recently, but had put it down to the menopause...

Anyone?

Not clear which heart rhythm the cons was referring to. It may have been AF? or just ectopics which are usually pretty harmless.
Weak heart muscle may mean some weakening or dilatation of the left ventricle secondary to the MV prolapse. Difficult to know without more info.. All really depends on the degree .
Did they change or introduce new meds?

The consultant was pretty non-medical in his language -heartbeat 'all over the place' and 'heart muscle seems a bit weak'. But the purple form I had to give to the person who fitted the 24 hr monitor said 'ectopics'. I'm not on any meds - never have been, apart from a brief period on a low dose of beta-blockers just after I'd had DS2, when the palpitations became more noticeable for a while.

I know that in the past doctors have always been surprised at the number of ectopic beats I have, given that I don't have much in the way of symptoms. I remember one GP panicking, referring me to the hospital and telling me to take an aspirin a day until I got there. But nothing has ever been found, apart from the MVP, which is apparently only a mild 'buckle' anyway.

ectopics is ok, and the tape is to pick up any other rhythm disturbance, just to get more information. The weak heart muscle is probably some mild change seen on the echo .. Wait until you go back and get more info about the echo.

If you have very frequent ectopics / abnormal rhythm it may affect the pumping action of the heart so the readings on the echo would be a bit down.

thanks Blingitback - that's very reassuring.

Wearing the 24 hr ECG machine today and am constantly aware of my irregular heartbeat, whereas I hardly ever feel it normally! is this usual - stress/adrenalin related?

I have a MVP and get palpatations, was once told that this is common with this condition.
My son recently had a 7 day heart monitor for palpatations and he became more aware of them whilst wearing it.

Sorry to ask, but how often do you have a check up for your MVP? After being seen every 2 years as a child i now have no regular follow up , unless i complain about symptoms.

No, nor me. I went for this check up largely as a result of my life insurance company saying that they would no longer cover me now that I'm over 50 and have palpitations! Was signed off from the cardiologist ten years ago (they monitored me during pregnancy). Was expecting just to get the usual 'its your mitral valve, don't worry about it', so this has been a bit of a shock.

I think its normal not to have follow ups unless you have symptoms. I am beginning to wonder if the life insurance letter may have been a good thing, if it's thrown up something different that needs treatment. I wouldn't have gone back otherwise as I've had no real symptoms, other than being more tired and occasional dizziness (which I just put down to being 52!).

Well hopefully it is nothing , but if it is , it is good that it is all being checked and if needed treatment can be started.

I last had a check up 4 years ago, but after reading your post i am going to try and push for another one.

Let us know how you get one and try not to worry to much in the meantime.

Take care.

Thanks - I do think its good to keep an eye on these things. Will let you know what happens.

Did it say multifocal ventricular ectopics? That would look like 'all over the place'.

OK any part of your heart can start a heart beat, normally it is very controlled and only starts from the heart's own electrical system.

Everyone has ventricular ectopics, it mans a bit of heart tissues has 'jumped the gun' and started the hearbeat from somewhere it shouldn't start.

Multifocal means that several different areas are starting the heart beat.

This might be due to an electrolite inbalance, which can be treated with drugs.

The tech doing the echo will have had trouble taking measurements.

OK you have not got cardiomyopathy, if you had that it could be measured, even with an irregular rhythm.

A good proportion of the population have mild MVP with no symptoms and no idea they have it.

It is monitored in pregnancy because that is a time when heart problems can develop or get worse. 1/1000 pregnancies result in a cardiomyopathy, from very mild to needing a heart transplant, and that's in the general population.

Try not to worry, I know that is easier said than done.

No it just said 'ectopics'. To be honest I am used to my heartbeat being 'all over the place' as it always is (particularly when it's being recorded!). I remember when I last went to hospital and the dr asked me 'Are you ever conscious of your palpitations?' I said, quite truthfully 'Only when I come here!' So I was expecting that bit. It was when the consultant mentioned the possible weak heart muscle that I got worried. Your post is very reassuring though - thanks. I have been worrying a lot less today as heartbeat has settled down again and I'm feeling fine.

It also said PAF at the bottom of the holter request form - have just realised that this probably means 'something atrial fibrillation'. Have been investigated for this before (10 years ago) but none found.

Paroxysmal Atrial Fibrillation... Irregular heart rhythm called AF occurring from time to time
It may have been ? PAF rather than PAF if you get my meaning though

Yes think it did have a question mark. Presumably if it had come up on the ECG they wouldn't have bothered with the Holter. Am hoping the results will be the same as 10 years ago, ie no AF. My pulse is irregular but not fast - if anything its very slow because of all the missed beats - when I'm having the ectopics its only around 50. Atm its steady at 100.

In medical talk that's ? PAF = query PAF? Is this PAF
Trying to look for little runs of PAF

Yes I realise that now - didn't take much notice of it at the start. Doesnt AF always give you a rapid pulse though?

Not always fast just different and irregular
But ectopics also make pulse irregular in different way
Try googling Atrial Fibrillation

Have done and think my pulse rate seems more ectopic than AF - I get 5 regular beats, then a missed beat, then a few more regular, then a missed one and so on. if I can feel the palpitations the missed beats are more often - when I was wearing the monitor it was one missed beat to every two regular! But the rhythm stays steady iykwim - I don't get a run of fast, then slow etc. But what do I know?

Sounds right to me... Regular with ectopics

Hmm - they've now called me for an exercise ECG on thursday...

That is a very good thing as they can see how your heart is working under physical stress and how quickly your BP and pulse recover after stopping.
I had it done in my early 40s, but was after my miserable performance that I was put on the 24 hour ECG, not before.

Good luck on Thursday.

I never notice my irregular heart rate when exercising so hopefully it means it'll be OK. However, I have noticed I get more tired when walking uphill - even gentle slopes - not out of breath, just tired.