PAF … ? Further echo

[Sniggetts]

Hi all, I’ve been quiet on the group for a while now as after my horrible introduction to rapid AF 18 months ago prompting a couple of stays in CCU things have settled on meds.

The cardiologist has discharged me back to the Gp , apart from ectopics & odd thumps/ bumps I am well on adizem & flecanide . 57 & female scoring 1 on chad vasc … so no anticoagulants til I’m 64.

My question is should I be asking for another echo or something? The one I had initially (18 months ago)was okish .. showed left atrial enlargement, mildly leaky valves & a hyperdynamic left ventricle! Cardiologist wasn’t particularly concerned .. other tests were ok too apparently .

Do I just leave things as they are “don’t poke the bear”… or push for a cardiologist check up like an echo ? Gp does annual bloods but that’s it really.

Any advice appreciated, please don’t worry me with scary stories as finally got on top of my anxiety about it all.

I am well , don’t smoke , drink alcohol & I’ve lost 2.5 stone since that all happened.

Thank you in advance. 😊

[Jalia]

If you've been given the ok by your cardiologist and you're feeling fine, having annual checks with your GP then what's there to worry about?

You had an Echo 18 months ago. I doubt whether you would be offered another so soon without a reason. They are not cheap .

Well done on losing all that weight. You must feel so much better and we are all told of the benefits particularly relating to AF.

Keep on doing what you are doing, enjoy life and forget about AF. Its bad enough when it happens.

[Sniggetts in reply to Jalia]

Thank you , yup you’re right. 😊

[Alicant in reply to Jalia]

Why are echos not cheap?If you’ve got machine it’s a technicians time?

[Jalia in reply to Alicant]

If you try to get one privately as I had to, two and a half years ago, it was £209 for hospital fees plus £150 for the Echo ( plus in my case OP appt for a further £150) . I've heard of higher charges. There is usually quite a wait for these on NHS due to high demand. ( I have one booked for this Monday at 8.10am...)

[Buffafly]

It’s natural to wonder ‘what’s going on in there?’ especially if you know it wasn’t 100% to start with but I agree with Jalia, you don’t need it unless you have new worrying symptoms. I can’t remember when I had the last one but I’m going to have one now because I developed left bundle branch block for no obvious reason so although the cardiologist thinks it’s just a progression of my PAF the structure of my heart may have changed. (I’m 79 so I hope you didn’t consider that scary!)

Well done and best wishes 💖

[Sniggetts in reply to Buffafly]

Thank you for your reply. Yes indeed , I just need to get on & enjoy life unless there are further concerns. All the very best with your upcoming echo , I hope all is sorted soon 😊

[Lupaal in reply to Sniggetts]

I have recently had another echo after 3 years , asked for by arrythmia nurse after another hospital visit but all was well so just under GP again now.

[FraserB]

I had to reply to your post since I was diagnosed the same time as you 18 months ago. Though I am in my late 60s, I too had my first emerg visit which was unexpected and the same horrible introduction. After the usual heart tests, etc and during all these 18 months later mine too has settled down. In the interim, I have seen my GP for the usual annual blood test etc. But I do believe looking after ourselves as you've said -- don't smoke or drink, losing weight and the correct medication does count enormously for keeping everything in harmony. Also I make plans most every day to do things I enjoy no matter how small. I do feel this calms my brain which communicates to the heart. 😊

[Sniggetts in reply to FraserB]

Thank you for your reply , yes indeed lifestyle has made a tremendous difference… long may it continue.

Making a daily plan to do little things you enjoy is very rewarding.

I have just had covid last week for the first time and have come out the other side of that which I’m pleased about … sure that weight loss & lifestyle will have helped too.

Hope you remain well 😊

[pusillanimous]

I have an annual echo - I have an anxious personality, so it helps me to know that my heart's intact and nothing is enlarging or looking as it shouldn't!

[Dollcollector in reply to pusillanimous]

It is 3 years since l had my last echocardiogram .My symptoms are worse. Medication makes no difference. I was refused another echocardiogram. The consultant said it isn't necessary. So l don't know what state my heart is in now.

[pusillanimous in reply to Dollcollector]

It's sad - just for your peace of mind and mental health it should be allowed. I'm in South Africa and have private health care, which is not so expensively alarming as it sounds. We have Medical Aid Societies to which we pay a monthly subscription and they cover most of our costs, depending on the plan you choose. It is not the same as insurance. Public health care is funded from our general taxes, not a special tax such as I paid in the UK before I came to live here.

[Dollcollector in reply to pusillanimous]

It sounds like a better system for your health care. The n.h.s. was wonderful when it was first introduced. Now there is not enough money, medical staff or hospitals to support the increased population. Also if more was done to support people in their own homes it would free up hospital beds. Thank you for your concern . All the best.

[pusillanimous in reply to Dollcollector]

Yes I was a little girl when the NHS was introduced - I remember half my class had glasses with one lens blocked out with sticking plaster ! It is a good system here, but the poor have to rely on an overused health system. The government is trying to introduce a National insurance scheme, but now they will struggle because we have had a General Election where Mandela's ANC party which has been in power for 30 years only got 40% of the vote, so we have a coalition and a government of National unity. WE have more private hospitals, doctors, specialists, radiology and pathology services in the private sector than the public.

[Sniggetts in reply to Dollcollector]

Goodness what a shame they won’t do another echo especially if symptoms are no better or indeed worse.

Hope you get sorted some how … it’s horrible.

[Dollcollector in reply to Sniggetts]

Thank you , l'm afraid when you get old you are just left to get on with it. I think they hope you will kick the bucket so that they don't have to spend any more money on you. Best wishes.

[Sniggetts in reply to pusillanimous]

Good plan x

[JOY2THEWORLD49]

Hi

Better without Alcohol.

I don't consume so could be why no symptoms after heart rate sorted down to 60s Day. 47 Night.

Try it.

Alcohol is poison and your body has to process and eliminate.

Good that you have lost all that weight. I could only do a 3kg and another 3kg.

cheri JOY 75 (NZ)

[ozziebob]

I requested a follow up transthoracic echocardiogram after 18 months because, like you, I was naturally concerned about possible developments in the condition of my paroxysmal AF heart. And, regardless, it's also helpful to me to read/compare the (different) measurements produced by a different sonographer. I was fortunate in being able to convince my GP that this was required because my first echo report only mentioned an atrial septal aneurysm (ASA) in passing, but had not measured its size or features at all. As ASAs and ASDs and PFOs can increase the risk of strokes, I suggested a second echo was vital to my health going forward. My London GP agreed and my second echo, in May 2024, occurred 21 months after the first in Feb 2022.

I would want a second echo if I was in your situation with the findings of the first echo you mention. Not unreasonable at all. I think you just have to organise your thoughts and concerns into a cogent argument to your GP so that the GP feels he/she can present a medical justification for it.

Good luck.

[Sniggetts in reply to ozziebob]

Thank you Ozziebob , it’s interesting you should say that as my echo did mention an “aneurysmal looking” area on the atrial septal, which frightened me so much I was onto the cardiac nurse immediately thinking I was going to pop! She just told me it was likely I was in an abnormal rhythm at the time of the echo which made it all out of sync & as the cardiologist wasn’t concerned I’ve left it ! Plus my Ct angiogram was normal too.

On reflection maybe I’ll look into getting one done privately at some stage.

Take care .

[ozziebob in reply to Sniggetts]

I think the cardiologists and GPs naturally want to reassure their patients and unless a finding requires urgent action, it gets reported as "no action required".

I am 20 years older than you, so my heart "bits" are probably a tad closer to their natural "use by" date, and that might explain my relative urgency to monitor these deteriorating "bits" with follow-up echocardiograms every 2 years if possible. I see others with more serious heart issues undergoing echocardiograms more frequently than this.

As for my atrial septal aneurysm (located in my atrial septum), it was discovered in my second echo that it's movement back and forth is minimal at the moment, and so "no action required". However, in 2 years I will be asking for echo #3 to continue to monitor for any changes.

I still think, with the serious heart report details you mentioned, that it's entirely appropriate to ask your GP for a referral for a follow-up echocardiogram, and not be forced to pay £300+(?) privately.

Good luck, and as Corporal Jones would say "Don't panic!".

[Sniggetts in reply to ozziebob]

Thank you , wise words indeed . Think I’m going to put my case together & speak to Gp

[mav7 in reply to Sniggetts]

showed left atrial enlargement, mildly leaky valves & a hyperdynamic left ventricle

In your post you describe your initial afib as "rapid" but is now controlled with medication.

Is your afib paroxysmal or persistent ?

Regardless, considering the findings on your previous echo it seems you should ask for a 2 year interval on echos.

[Sniggetts in reply to mav7]

Apologies, it is paroxysmal… running at about 250/280 for hours , hence several stays in CCU .

Thank you for your reply , yes I don’t think 2 yearly is excessive.

[mav7 in reply to Sniggetts]

Best to You !

[Ppiman]

I would definitely want to have regular echo scans, myself and perhaps even a cardiac MRI at some point - but I am, like you, an anxious individual. Treatment seems to be to keep the weight and blood pressure right down and to be sure any diabetes is strictly controlled.

Overall, though, I suspect the condition you have is nothing like what reading on Google might suggest and is being well controlled. My own experience is to trust the real doctor rather than to trust Dr Google.

Steve

[Sniggetts in reply to Ppiman]

Thank you