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...

I have been put on beta blockers and will get the ACE inhibitor once they've settled the dose.

BP first thing this morning was 172/102. I've taken it again since posting and it was 134/86.

Have just been down to town with DS1 (an easy level walk) - had some chest discomfort before I left and it got worse while I was walking, moving into my shoulder blades. Am now resting (and have taken Gaviscon in case it's heartburn) and it's mostly gone off, but still feel slight discomfort in chest. Am wondering if I should ring out of hours doc.

Lirael
the 134 systolic is fine, the 86 diastolic is only just a tad high.
There is always a surge in BP after getting out of bed in the mornings after a night sleeping and shouldn't be taken immediately. Do not know if your reading was a normal one.

I'd have taken it after you got home especially as you had the chest "discomfort" while out with DS1 . Are you feeling better now as your post was almost 1. 5 hours ago?

Will be off-line now for 1.5 hours. Will pop back in when back.

Yes thanks Digerd - still resting but feeling much more comfortable. Pain went off after taking the Gaviscon. It always does, which is why I've assumed it's heartburn, but when I read up about angina, it says that goes off after a while too. So none the wiser really.

Hi, I'm back again. I have had that occasionaly, but always in bed and so scary. But I wait to feel a little 'plop'go off inside me and know it is only wind. But can be very painful and creep up into my neck and up to my eyebrows.
Glad you are feeling better and able to take it easy.

strangly, my previous ECGs were noted with "Abnormal. L Atrium enlargement." But the Echo revealed this was not so.

An ECG just records the electrical activity of your heart, you need to do an echo to get the actual measurements.

Lots of things can make something look like something else. You know those tall lanky teenage boys you get? Their ECG often looks like they have ventricular hypertrophy (thickening) but it is actually the shape of their chest and how close the heart is to the electrodes.

Some 'abnormalities' are racial variants, as ECGs were invented in Europe the 'normal' ECG is based on an adult white male.

The main one is the changes the ECG goes through from a baby to an adult, the T waves are inverted in a baby and gradually become positive by about 20, but it is not unusual for them to remain inverted in people of African descent until they are 30.

Sometimes you can make them 'flip' to positive by asking the person to take, and hold, a deep breath.

Baby ECGs - you can put the left leg electrode on the baby's forehead and get the same result. Useful if they are wiggly.

Chest pain got gradually worse yesterday and I ended up going to hospital of advice of 111 doctor, who also insisted on calling an ambulance. Paramedics, while reassuring me I wasn't having a heart attack, also took it very seriously and were worried about my irregular pulse. Gave me angina spray, which relieved the pain in minutes, making them think it was definitely cardiac. However, after blood tests, ECGs and a chest X ray in A&E, all of which were clear (apart from the multi-focal ectopics) the dr there said he thought it was more likely to be gastric pain exacerbated by anxiety (which apparently the angina spray will also relieve). My blood pressure was 128/77 by the time I left!
Am feeling much more relaxed about everything this morning.

Our NHS is fab - from the 111 service (which I know has had criticism) to the paramedics, A&E nurses and doctors - couldn't fault any of it. Fast, efficient, kind, willing to take time to explain things - there was a very elderly and slightly confused lady who'd had a fall/suspected mini-stroke in the cubicle next to me and they couldn't have been more gentle and supportive with her.

OP
128/77 BP is a very good BP. What a roller coaster your yesterday was, but turned out fine. You do have wonderful NHS hospital drs and nurses in your area. Sounds very scary for you though.

My BP and pulse go ballistic when I am het up. At Gps once it was 180/100. He tried it 3 times but wouldn't go down and just smiled as knows me. .
Neurotic, moi?

sashh

Very interesting information re lanky teenage boys, babies and Africans under 30.

One young ECG technician, in 2005, was so concerned about my ECG, I heard her on the phone asking if she should call an ambulance. I felt fine, so when she returned I said to her "Am I having a heart attack?

It wasn't until 2 years later while having an ECG privately, that the dr said "You've got a heart murmur haven't you". I said bemused "No, always had odd ECGs, but nothing is wrong". Listened to my heart with the stethoscope and said " Yes, you do have a heart murmur I can hear it quite clearly". Then I had the echo which confirmed it.. I was a bit shocked. My ECG in 2003 had been exactly the same as 2005

Glad you had a good experince lirael and feel little more reassured.

That's really interesting sashh.

dd's ECG generally gives the uninitiated the heebie jeebies. Oddly chaotic ST segment caused by myocardial ischaemia and hypokinesia. (she has anomalous LCA from PA amongst other bits and pieces)

Had the results of my treadmill and ECG tests this morning. Treadmill test showed ' frequent ventricular ectopics that were not significantly suppressed with physical activity ....short runs lasting a maximum of 5 beats'. It also says that ST segments were difficult to assess because of the ectopics, but 'the maximum was probably 1.65 horizontal ST depression'. It also confirms that my BP dropped at peak exercise.

24 hour ECG just repeats the finding of frequent PVCs (24.3% of total heartbeat) and a short run of atrial ectopics.

I think I am probably looking at some degree of heart problem - have accepted that this is likely.

Hi Lirael
A drop in BP during the stress test "may be a sign of a heart problem", I have read on a google website. But I know nothing of this myself as I was given no details just everything OK.

I do hope the MRI scan can diagnose what is the cause as the echo couldn't. Did they say how long you would have to wait for it?

no - last letter to GP said 'in the near future' so probably in the next couple of weeks I should think. Would like to get it over with!

When I had the blood tests last weekend the A&E dr said my troop in levels were absolutely fine - no sign of any damage to the heart muscle at all (apparently damaged heart muscle leaks enzymes into the blood). I am wondering if this means that any degree of heart disease would show up in this test - or just heart attack type stuff. does anyone know?

oh stupid iPad - troponin levels not troop in!

Morning Lirael
I do know that a suspected heart attack, can be diagnosed with a blood test, up to a certain length of time afterwards, and wondered if they had done that test for you . Glad to hear that it proved not to be.
However, I did not know it was the enzyme Troponin but knew that it remains in the blood stream only temporarily.

That he said there was no sign of heart muscle damage, sounds really encouraging, but only a Cardiologist can explain if that is related to the blood test at that time, or the general condition of your heart muscle.

You said they explained that your ectopics could give false images on your Echocardiogram, and it might be what happened. The specialist admitted the results were most confusing in that letter you got.