What do these results mean? Help

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Vonnie
New Member


Date Joined Oct 2017
Total Posts : 2
   Posted 10/27/2017 9:39 AM (GMT -7)   
Hi. My husband was rushed to the hospital at the end of August with a pulse rate of 38bpm. On the 1st Sept, he had a two lead pacemaker fitted to regulate his pulse (currently set at 60bpm by the pacemaker).

Can anyone help us understand what the heck the discharge letter means? We have visited our GP, phoned the cardiac clinic - all in an attempt to get an easy to understand explanation of all the medical jargon. No help. One says he has had a silent heart attack, one says he hasn't. One says there is heart damage (apparently shown during the echocardiogram - which he was not allowed to see) nor was it explained where the damage might be or what effect the damage might have. I'll post excerpts from the letter below. If anyone can translate we would be eternally grateful. It is so difficult to know what his level recovery should be at now when no one will take the time to explain it. Obviously, we understand that his coronary arteries are all clear.

His 6-week Pacemaker follow up check is in DECEMBER! His 6-week follow up appointment with the cardiac clinic is in FEBRUARY 2018!!

HERE WE GO WITH THE EXCERPTS:

'SUMMARY: Severe left ventricularsystolic dysfunction (LV EF 35o/s, normal QRSd)
Probable septal infarction and aneurysm
Paroxysmal iRRegular atrial tachycardia
Dual chamber pacemaker for sino-atrial disease
Possible aortic root and ascending aorta dilatation
Unobstructed coronaries'

'Transthoracic echocardiography on 30 Aug 2017 showed moderate left ventricular (LV)
dilatation with severe systolic dysfunction (ejection fraction, EF, 35o/o). There were
aneurysmal mid-ventricular anteroseptal and inferoseptal segments and basal anteroseptal
and inferoseptal akinesia. The inferolateral and all apical segments contracted well. All other
segments were hypokinetic. The aortic root (41 mm) and ascending aorta (42 mm) were
reported to be dilated but were not corrected for body surface area.'

'The aetiology of his left ventricular dysfunction is unclear. He does have septal Q waves with
a mid-ventricular aneurysm, suggesting infarction. However, invasive coronary angiography
revealed unobstructed coronaries. Differential diagnoses include plaque rupture with
subsequent recanalization and thromboembolism due to episodes of as yet undetected atrial
fibrillation.'


Help anyone?? confused

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15321
   Posted 10/28/2017 6:12 AM (GMT -7)   
Hi Vonnie & welcome to the forum. First & foremost, your husband is entitled to a copy of his medical records. He can call his drs office & obtain a copy of the echo & everything. He may have to pay a copy fee charge. When I go to my cardiologist for testing & return for the results I am given a copy of my testing. Not all drs do this but mine does. But, regardless he can call & ask for medical records & tell them what he needs copy of. He does not need to go into any detail other than he keeps a copy of his records for his own personal use. The discharge papers you all were given, no wonder you are confused. As for the silent heart attack, yes people can have one & never know it until they have a cardiac work up, so please try not to stress over this. My brother had one & it was discovered this way too. By the way, when I have testing done, the techs are not allowed to discuss the results or what they saw this has to come from the dr.

When he goes in for the pacemaker check up all they will be interested in is making sure he is not having issues with it. My husband has one & he has to go in for check ups on his. He was not seen for some time either after his pacemaker was put in either. In the meantime, try to relax. Make a list of questions for the cardiologist. If he feels for some reason he cannot wait until the appt time he can always try to be seen sooner. I can assure you, if he were in any immediate danger with everything that has taken place, the drs would have told you all.

I can understand your concerns because its all been a shock to you all. Thats a normal reaction. Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

theHTreturns...
Elite Member


Date Joined Mar 2009
Total Posts : 20048
   Posted 10/28/2017 7:05 AM (GMT -7)   
welcome and yes, if they thought not safe then immediate action would have taken place. and yes to susie, you can always ask for a quicker appt. esp cardiologist rooms!!! keep strong.

Vonnie
New Member


Date Joined Oct 2017
Total Posts : 2
   Posted 11/10/2017 2:30 PM (GMT -7)   
UPDATE: Thanks to those who replied.

Had an appointment yesterday at something called the Ambulatory Care Clinic. Somethings were explained a little better.

Firstly: My husband (who is 56) has NOT had a heart attack and should not have been told by the lady doing the echocardiogram that he had.

Secondly: His heart has NOT been damaged as he has not had a heart attack.

But..

He is in heart failure... his heart is not pumping very well at all (quite a shock to hear for someone who has always taken care of himself, exercised and had a naturally low pulse rate). His pacemaker is keeping his pulse set at 60 beats per minute as, on its own, his heart was struggling to keep in the mid 30s bpm. The lower left ventricle, in particular, is very weak.

He is supposed to be on some sort of medication - which hasn't been actioned by the department concerned so the doc in the clinic yesterday has to write to the cardiologist, who will then chase up the heart failure team to get the correct medication prescribed.

He has also been told he is to have an MRI scan in January - which he should have been advised of. No letter, no date - so again it will have to be chased up.

Why can't they do all the test etc in one day without all the darn letter writing, emailing to different departments and, ultimately as seems to be the case here, not doing what is supposed to be done? Grr.

Now a waiting game again and we will have to chase up through our GP as well to make sure he is given the correct medication for his heart failure. It may be free but the NHS is not what it used to me. Oh for private health insurance.

T

theHTreturns...
Elite Member


Date Joined Mar 2009
Total Posts : 20048
   Posted 11/10/2017 10:17 PM (GMT -7)   
yeah the letter writing is a bit much. here they do it via portal. (australia) people who do echos are not cardiologists, and you right, should not have said anything. getting the right meds is important, very. i understand hospital systems well...esp mental health. i digress. however in a perfect world all could be done in one go, however alike peoples arteries they are just clogged. keep strong and keep bugging them. ht.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15321
   Posted 11/11/2017 7:55 AM (GMT -7)   
I am very happy to read that you finally got some correct information from the drs. I did not realize it was the tech doing the echo that said your husband had a silent heart attack. Wow, had something like that happened here in the states, that tech would be without a job. I have been doing echos since I was 28 yrs old & now 64. Not once has a tech ever made a comment about my echo. I did ask on the first one & was promptly told my dr would review the test & give me the results.

Yes, your husband will need to be on this medication for one year because of the pacemaker. It is important that he start on it as soon as possible. I have no idea how your healthcare system works but I would be making phone calls about lighting a fire under someone to get that medication. They stressed to us he needed to be on it immediately, not when someone got around to it. We were given the script before the pacemaker was put in & the hospital gave him his starting dose. I cannot remember the name of the medication he was put on. There are a couple of them. They recommended a new one that came out but it was super expensive. So, he was put on the older one & had no issues. I think the dr was just pushing the newer drug because he had no issue with him taking the older one. My husband has heart failure & AFib this is why he has a pacemaker.

Keep us posted.
Susie
Moderator in Chronic Pain & Psoriasis Forums
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