Please help in making sense of Echostress report.

[DizzyD]

Hi all I am new here and very confused and frustrated trying to comprehend what my Echostress report (done via a private cardiologist) actually means. I have not had a consult with private cardiologist yet to discuss the report and Would really appreciate some feedback from members on this site as I am at my wits end and really scared. In truth, feel like I am going crazy.

Cardiologist initiated the echo stress after CT scan showed LAD disease. What is LAD disease mean?

What follows is most of the report which I don't understand and hope you can help me. Can't go for follow up private consult to discuss findings because I have ran out of money.

STRESS RESULTS: (pre-exercise) heart rate 71 blood pressure 157/83.

Exercise 1: (3:00 mins) HR 121 BP 215/93.

Exercise 2: (3:00 mins) HR 242/91

STRESS test stopped after 6mins due to high BP.

STRESS FINDINGS: Baseline ECG showed sinus rhythm, occasional atrial ectopics, and Q waves in 1, a VL and V1-V3. Stress ECG showed only minor AT straining the inferior and lateral leads which was associated with severe increase in blood pressure: 242/91mmHg. Patient did not have any chest pain at this time but test had to be stopped due to hypertension. ST change normalised quickly in recovery.

LEFT VENTRICLE: Normal in size.

RIGHT VENTRICLE: Normal in size and function.

ATRIA: Left atrium moderately dilated. Right atrium size is normal.

MITRAL VALVE: There is moderate to severe mitral annular calcification. There is mild mitral stenosis which is due to annular calcification. MITRAL leaflets are thin and pliable and open well. Mean PG: 4mmHg. Mitral valve area by planimetry and pressure half time =1.5cm2. There is trace mitral regurgitation.

TRICUSPID VALVE: Normal in structure and function. There is mild tricyclic regurgitation.

AORTIC VALUE: Normal in structure and value.

PULMONIC VALUE: The Olympic VALVE is not well visualised.

VESSELS: The aortic root is normal size.

PERICARDIUM: There is no patriarchal effusion.

Present heart symptoms. Daytime. Heart feels ok just sitting or pottering about at home. Usual faster heart rate going upstairs with slight breathing problems which settled down quite quickly. However when I take dog out she pulls me (excited to reach play area) my pace picks up as does HR which I am not conscious of. However, within a matter of minutes tightness in chest, difficulty breathing, leg weakness, total slow down, then I have to stop altogether and eventually walk at a snail pace with tightness in chest and breathing still difficult. In cardio terms can anyone tell me what the medical diagnosis for the above symptoms COULD be?

Middle of night between 2-3am occasionally get woken up by strange electrical buzzing sensation, in heart (quite hard to describe) which concerns me. Happened last night at 2 20am. Have stayed awake since then and decided to write this post to hopefully find some answers and perhaps a solution.

Sorry this post is so long. Would really appreciate some feedback.

Kind regards to all

[Sunnie2day]

Hiya, and welcome to the forum!

Your best most reliable information is going to come from the consultant. You might also give the nurses on the BHF Heart Helpline a go, the following link is to their contact details page:

bhf.org.uk/informationsuppo...

Please let us know what you find out, and again, welcome!

[Smileyian]

Hi DizzyD. Many will likely advise you on here but you really need a follow up with your cardiologist. May I just respond as a lay person who has experienced Afib for over 30 years and now diag with artery spasms. Of course your exercise BP is concerning and the test was terminated thus. There also appears to be (probably) some valve regurgitation or leak. LAD is an important main artery and indications in your comprehensive report seems to indicate some stenosis or blockage in your Left Anterior Descending artery. Your pain could be mild angina the way you describe it. All above is routine for a cardiologist and I sincerely hope you can find the funds to follow up. I am confused as to why the private cardiologist is not following up the extensive report you have presented. I wish you all the very best with your follow up and medically professional answers from the cardiologist.

[DizzyD in reply to Smileyian]

Hey Smileyian thank you for your most welcome and thoughtful reply. Really appreciate your feedback. Have done a bit of research since sending my first post. Googled mitral annular calcification MAC which is fitting with the report and also to what you pointed out....stenosis!!! Scary stuff, as you know with the heart issues you have had for 30 years. Clearly you have learned some cardiac terminology and knowledge over time and I agree with your suggestion of angina causing me problems on a daily basis. Cannot take bisoprolol though cos I go even slower than a snail all day long. Can't even get out of bed using bisoprolol and this will never do.......my precious energetic dog needs to go out three times a day.

So I have stenosis (hope this the correct medical name) and angina type symptoms.

Like you, I cannot understand why I was not contacted by my private cardiologist to at least discuss the report. Going to contact him asap try and get a face to face appointment before lockdown gets worse.

Feeling rather despondent though because their is no treatment for MAC apart from quite complicated surgery which I may not be suitable for. If I am suitable will have to sell my house and buy a tent for me and my dog.

Have a rewarding day Smiley. Take care, stay safe....sincere thank you.

By the way what is artery spasms? Are they jerky sensations like stretching an elastic band then it pulls back?

[Prada47 in reply to DizzyD]

Hi Dizzy Quick question is why have you not seen an NHS Cardiologist or have you spoken with your GP since having the Test ??

Hands Face Space

[DizzyD in reply to Prada47]

Hello Prada my initial consult with NHS cardiologist January 2020. He proposed echocardiogram, CT scan which I was waiting for but covid lockdown happened. So with the easing of lockdown knew I would have to wait hell of a long time for cardio tests via NHS. So I went private in NHS hospital face to face consult. Early August. My cardio symptoms were getting much worse. Money certainly does talk hey? Pity I could not stretch it lol.

I went to top heart hospital in North West NHS. It was deserted, quite surreal, apart from a few private patients and lots of NHS staff doing nothing really because they had no patients. What about the back log of desperately ill people waiting to be seen? The mind boggles.

Spoke to GP few days concerning another issue. As an afterthought I mentioned I had echostress report. He asked me to hand it in to the surgery which I will do eventually just to go with my medical records. Knowing my GP surgery as I do they will loose it.

Not going into boring details here but from a long history and experience of NHS treatment or should say mistreatment, I have totally lost faith in NHS.

Sincere thanks for your reply and questions Prada

[Smileyian in reply to DizzyD]

I sincerely hope you don't have sell your home DizzyD. Altho I am British, I have lived in Singapore for 20 years and I am now 76. May I ask how old you are and also could I enquire why you could not use the NHS if funds are an issue. I understand the NHS have excellent cardiac services - according to many on this forum. Like you, I also have an energetic small dog who needs 3 walks a day - not quite sure who takes who for a walk. You take care and get sorted as soon as possible.

[DizzyD in reply to Smileyian]

Hello again Smiley if push comes to shove I will sell my home because my health comes first. My home is just a material thing and replaceable. Cannot regain health re: if heart issue is left to crumble like a derelict house. NHS is bad too, lots of people falling through the net who really need medical treatment. It's the system not the dedicated NHS staff. If I was to be treated for my heart issue via the NHS I would have to wait years for treatment due to backlog of cases they have to deal with due to covid lockdown. Looks like another lockdown could happen too. So time is not on m my side.

I am 69, young at heart and was very energetic and active, (which was why I choose a bearded collie) until last year when health started to decline. Used to take my Dizi (dogs name) out three times a day to trek the sandunes, woods and beaches. She chased rabbits, birds and squirrels....now she chases flys in conservatory and birds in garden wondering what's happening to her mum. Ohh yes she drags me up street to smallish field to play but I can't interact with as much, just stand on path throwing ball or stick due to check pain and breathlessness.

But I will get well for her and myself.

Sincere thank you for your concern. Have a brilliant day. Lucky you living in Singapore

[Smileyian in reply to DizzyD]

Thanks DizzyD. You will get better with your positive attitude. Keep us updated.

[Mikedabike]

Hi DizzyD, after reading your post and replies, a couple of things spring immediately to mind. I won’t go into too much detail here, but like yourself I have had issues with very poor treatment, or indeed no treatment at all from the NHS over many years.

I had an AVR in December 2019. Prior to the AVR I too sought private consultations thinking I would get better or prompter service. It didn’t turn out that way, and in the end, the only way I finally got listened to, was to turn up at A & E on two separate occasions explaining my symptoms. When they finally gave me a CT scan, they would not let me leave the hospital. I was kept in for a fortnight and had my AVR. Prior to that last visit, all my concerns over my heart problems were always dismissed as outwardly I presented an image of a fit, healthy individual. Once they kept me in, I have to add that the service from the cardiac team was exceptional. The problem was actually getting them to listen to me in the first place.

At the very least I would have thought that your consultant should have provided your local GP with the Echostress results. I recall that in my case, the cardiologist forwarded both myself and my GP copies of any examinations within a week or two. I would then have thought that if you let your GP know that you have no further funding for private healthcare that they would be duty bound to immediately refer you to NHS cardiologists. I have only learnt through bitter experience that the only way to get anything done is to keep pushing and pushing. I am lucky enough now to have found an excellent GP practice where I live.

Don’t give in, keep pushing, you know yourself how you feel and it is obvious how your quality of life is not getting any better. Keep pressing your local GP.

Good luck in your progress.

[DizzyD in reply to Mikedabike]

Hi Mike don't know what AVR but will check it out later. Really good advice Mike thank you most sincerely.

I noted you had your surgery December 2019. Phew lucky for you....there was no covid lockdowm!! Brilliant timing hey. So pleased things worked out for you, well done to you and the NHS with its brilliant staff.

Like you when visiting my GP with signs/symptoms of cardio problems during the past few years, outwardly I present an image of being fit and healthy. At one time I had ECG during a visit and was told I had a silent heart attack. That was it....dismissed so go home now. Collapsed a few days later through breathlessness etc and daughter took me to a+e. They done 3 ECGs an blood tests.....no signs of silent heart attack.

More visits over time to GP with heart symptoms....dismissed. It's wrote in my GP medical notes: HEART PHOBIA.... The pen is mightier than the sword!!!

More stuff like this but not necessary to go into detail. Lots of a+e admissions. EGGs and bloods tests. Nothing else.

October 2019 after months of encroaching heart issues my health deteriorated greatly. Bedridden...!

January 2020 went to see a private cardiologist who wrote to my GP advising him to put me on certain meds and told him to refer me to a NHS cardiologist which he did. The private cardiologist listened to me...I was not dismissed. Had first consultation with NHS cardiologist February 2020 who recommended echocardiogram and CT scan. Never got them because of covid lockdown. Was so unwell during lockdown.

Soon as possible (after lockdown) went private again. So glad I did, got echocardiogram CT scan and echostress and a diagnosis. Now I have something work with. If I did opt for NHS treatment I will have hellava long wait. Time is not on my side.

Really do appreciate your feedback Mike. Totally understand where you are coming from re:your success story. God only knows what position you would be if you had not gone to a+e when you did. Eureka!!

Kind regards have a brilliant day.

[Smileyian in reply to Mikedabike]

A very concise and admirable reply. Unfortunately it is sometimes the old adage "those who shout loudest, get heard".

[Tessie28]

Hi Dizzy,

get your private cardiologist to feed back the information in terms you will understand. I went private in the early stages and was then transfered over to my heart surgeon's NHS list. Try not to worry too much.

Don't lose faith in the NHS. At Harefield they saved my life. We are lucky to have many talented heart surgeons in this country.

take care

[DizzyD in reply to Tessie28]

Thanks Tessa. Great it all worked out for you for within the NHS. Go without saying NHS as saved millions of lifes and do brilliant work which they are dedicated to. I take my hat off too them.

But one must not forget there is a post code lottery along with high amounts of sick people (new patients and pre-existing ones) creating a backlog of work for NHS. God only knows when I would be my turn in the backlog!

If I am trying to jump the queue by going private so be it. It may work in my favour it maynot. Another way of looking at it is by paying for my treatment I am putting money in the NHS coffers.

Have a wonderful rewarding day.

God bless

[Tessie28 in reply to DizzyD]

Dizzy, you can name the consultant you want. When I was in Harefield people came from all over the UK for their operations. Although no visitors now in normal times they have a special hotel on site for relatives.

[DizzyD in reply to Tessie28]

Hey Tessa what procedure did you have? You must have been in dire need of the surgery at that time. So pleased you are doing so well.

My stenosis diagnosis (MAC) is not life threatening in the short term but left to deteriorate over time it will get worse and become life threatening I should imagine. Bearing that in mind I would sooner have procedure done asap due to the impact it is having on my quality of life.

What is the name of your consultant at Harefield? Got to start a list of possible consultants at some point so might as well start now.

Thanks a million....Have a great day

[Tessie28 in reply to DizzyD]

Hi Dizzy I had AVR. First appointment NHS 10th Jan, operation 9th March. I am with Fabio de Robertis. He first worked at Harefield under Sir Magdi Yacoub. A quiet unassuming man from Naples. What a star! There are lots of others of course and some will blow their own trumpets! As far as a cardiologist is concerned I started with Dr Georgios Karagiannis. He refered me on to Fabio. Again a real treasure, his private patients are given an email and he responds within the day.

Right from the start I was not prepared to wait around because of the severity of the stenosis. Glad I did not listen to my GP... wouldn't be here if I had which is very scary.

Good luck on your heart journey,

Tessie

[Thanksnhs]

Hi sorry to hear your problems with the NHS, I have been the opposite, from being taken to A&E by ambulance nearly four years I didn't even no I heart condition, I seen a cardiologist almost every six weeks, 10 weeks ago today, In the middle of the pandemic I received a transplant, home in less than four weeks, the care and consideration I have had from all the NHS staff has been amazing over the years, I had every test available, the after care is also amazing, but on the other hand I cannot say the same for the gp's shocking treatment from them, ah well can't win them all, I wish you well and I hope you get all the treatment you need, take care char

[Tessie28 in reply to Thanksnhs]

Hi wow well done to you. My heart surgeon is also a transplant surgeon, amazing guy. The bravery of the transplant patients I met while in hospital is really aweinspiring. My GP is another matter altogether. He hates being told what to do by the people at Harefield. I used to like and respect him but I have lost all the trust. He should have done more years ago and I should have been on statins.

I hope your recovery continues unhindered.

[Thanksnhs in reply to Tessie28]

Thank you just walked to morrisons and back carrying a small amount of shopping, I can't drive yet, it's amazing just to be able to do it, I know recovery will have a few setbacks, but hopefully it will all work out, after being so ill for years it will be lovely, but as for the gp 🙄🙄take care char

[DizzyD]

Wow that's amazing thanksnhs. What a fantastic post to share. Well done to you and the NHS. Thing is even though I am going for private treatment my procedure, will be carried out by an NHS consultant. As your experience shows I will be very good hands.

Thanksnhs....Have a delightful prosperous day

[Thanksnhs]

You too, enjoy the last of the sunshine, I hope your treatment goes well take care char