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...

Before I started - when I was lying on the couch

Oh god- have made the mistake of googling 'a drop in systolic blood pressure during the stress test' and have found out it can indicate myocardial ischemia (blocked /partially blocked arteries). Would they have stopped the test if they suspected this?

Neurotic, moi?

Right - Dh has just brought me a letter that arrived this morning while we were both in a meeting about DS2. It was under a parcel and he's only just found it. It was written to my GP by the consultant who saw me last week after I'd had the ECG and echo. It says:
" ECG showed a number of ventricular ectopics and partial right bundled branch block. To my surprise her echo from the 4th June shows some dilation of the left ventricle and systolic function is described as 'at least moderately impaired'. her ejection fraction was around 40% (normal above 55). There was only very mild mitral regurgitation with no true prolapse. There was mild right sided ventricular impairment. I do not have an explanation for this lady's reduced LV function, it is clearly not related to any mitral valve prolapse."

He then says he's referring me for the Holter and treadmill test and also for a cardiac MRI scan. He wants me to start on Beta blockers and an ACE inhibitor.

Now am really anxious

Bump

I'm here OP. My goodness. Why did you get that letter as it is meant
for your GP?
Tomorrow you must take the letter to your GPs surgery, as urgent regarding the specialists recommended medication. I assume he didn't get a copy of this letter and has not prescribed you this medication.?

This medication is standard treatment .

Hi Digerd. Thanks for replying - I really need to talk to someone! Dh is here, but is being his usual calm self - which makes me feel daft for being anxious.

The letter is a 'patient copy' of a letter that I presume has been sent to the GP today. I think I've been sent it so that I make an appointment.

I am really surprised that the letter was meant for you. Oh well, he was right about your Mitral Valve not being the cause of your LV and systolic function impairment. His words "Odd" at your ultrasound is exactly what further study of the images confirmed. But not good that he doesn't know what is causing it. That is worrying for you.

The MRI scan hopefully will reveal more answers.

He didn't mention your Aortic valve function - mine is moderately bad and I think my ejection fraction is about the same as yours as regurgitates back into the ventricle instead of going through the valve to the main artery. But my dyastolic - the lower BP number has reduced from in the 70s to low 60s which is the result of the back flow and pooling in the LV. My echo showed a good function of the LV though < 6 years ago>.

I have to retire now as must be up early tomorrow morning.
I suggest you get on that medication tomorrow, as think you will feel less anxious receiving treatment.
So, the results of the stress test and MRI scan appt and results still to go. Good luck. Will pop back in tomorrow when I can.

Thanks Digerd

Would they have stopped the test if they suspected this?

They wouldn't suspect, it is quite clear on the ECG and yes they would have stopped and probably given you GTN (spray under tongue).

Sorry forgot to mention the BP.

You don't need to do anything with the letter, it seems to be routine at some hospitals these days to send a copy of correspondence.

Thank Sashh, that's good to hear. What's your view of the letter? (I know you can't diagnose me!). I am thinking that there is more than likely something that needs treatment.

Morning OP. Did you sleep well? Do contact your GP and ask to be put on the medication your specialist recommended asap.

I got a letter from the private specialist, but was not so personal and chatty. Under the NHS, I never got one, only GP and I had to ask him for details.

Morning Digerd. Surprisingly I slept fine! Am going to contact my GP as soon as they open - have a list of questions.

My view of the letter, they don't know what is going on, yet, but are doing more tests to find out.

I doubt you have aortic regurge, that would be mentioned in the report and it normally causes the heart muscle to thicken rather than enlarge.

In your original post you said that you have had ectopics for many years, maybe it is something you were born with?

Sometimes these things are not picked up until adulthood, are of medical interest but don't cause any/many problems so are left alone.

The strangest thing I have ever seen on an echo was someone with no valve on one side of his heart but with both ASD and VSD (two types of hole in the heart) so the blood was flowing in the most peculiar way. It was picked up when he was in his 20s and other than an annual echo he had no treatment.

Have you had an echo before? And have there been any changes if you have?

digerd
My local hospital only sends letters to my GP, but I had some treatment out of the area and that trust always sent me a copy.

I last had an echo 25 odd years ago, in my twenties, and all it picked up was the MVP, which I was told later was only a 'mild buckle' (confirmed by this current letter).

The only thing I've been to the GP about in recent years is intermittent heartburn - this has become like more chest/sternum discomfort recently but I didn't go back to the doctors because I just assumed it was heartburn. Usually comes on after exercise (but not all exercise) and/or eating, occasionally radiates to shoulder blades. Goes away after 30 mins or so (I usually take Gaviscon). Now of course I'm wondering whether its angina. Sounds like I'm posting by drip feed - but I really didn't think about this until yesterday

Back from the GP, who has started me on 2.5 mg of Bisoprolol. She was lovely - took time to discuss it all with me and answer questions. I was quite cheered up by her attitude - she read the letter (they haven't received it yet!) and seemed to find it all fascinating! Summary of discussion:

She's booked me in for a thyroid blood test - I have some symptoms, like loss of outer eyebrows, feeling the cold etc.She agreed that my chest pains could be angina and I should ring the surgery if it happens again and lasts longer than 10 mins. That I should continue with normal activity but not climb hills with huge bags of shopping......She said that the stress test would pick up any signs of coronary artery disease and that they would whip me in for an angiogram if this was found.
I shouldn't worry about cardiomyopathy as that would have shown up as a more global dilation of the heart (like BB said upthread). She said she thought the beta blockers would help with my anxiety about the MRI, but would give me diazepam if I felt I needed it. She was very reassuring about the MRI - said I would be able to tilt my head to see daylight!

I said as I left that I presumed they would find something wrong, and she said not necessarily. So I'm going to try not to worry until I know - take each test as it comes. As we both said, if there is a problem, thank goodness it's been picked up.

Sorry, am self-obsessed at the moment. Badvoc, how are you?

OP
Just popped in for a few minutes. Glad you saw GP this morning and been put on some medication. But they have not received the letter yet.? Good job you went today with yours!
Hope you get the stress test results soon and your MRI scan appt.
As GP said, it may not be anything to worry about

With my aortic regurgitation, as sashh said, there was a very slight thickening of the walls - insignificant they said, phew-. But, strangly, my previous ECGs were noted with "Abnormal. L Atrium enlargement." But the Echo revealed this was not so.

The MRI will show more detailed/accurate info. I never had one

Neurotic, moi?

They've got a new one at the hospital I go to, so maybe they're keen to use it!

Just popped in again.

I had an MRI scan on my knee a few years ago. It didn't hurt but the magnetics kept making my knee muscles jerk in spasms, and I wasn't supposed to move. I thought it might have spoiled the images and made them all blurry, but I wasn't recalled to take it again.

Just in case your chest muscles do a bit of 'twitching', don't worry

Got to go out again.

Hi lirael - sorry you have some worries about your heart.

My dd (now 19) has dilated/impaired LV function and dilated RV due to a congenital issue. She's had all the tests multiple times including MRI, myocardial perfusion scan and stress echo. It is quite normal for some units to send you the letters though it can be a worry certainly at first when you don't really know what's going on.

Hope you get to the bottom of it very soon.

Thanks DameSaggars. Your DD has had to go through a lot at such a young age. My 'funny heart' was first noticed by a GP when I was very young - he thought it was a heart murmur - but it was never followed up until I was in my twenties and the MVP was diagnosed (which now seems to be a red herring). I do have a slight suspicion that whatever is there might have been there all along (and as Sashh says, has only become significant recently).

Now add raised blood pressure into the mix. Am hoping it's just anxiety.

Hi lirael

What is your blood pressure? Have you taken it at home with your own machine? Or do you mean the 158/88 reading before your Stress test?

ps. You haven't been walking up hills carrying heavy shopping again have you?

Did your GP not prescribe you an ACE inhibitor as mentioned in letter lirael?These are often prescribed for BP problems but have the added benefit of reducing the 'load' on the heart. dd has taken these since she was a baby.