Can you have heart problems with a normal echocardiogram?

[KittyKitten]

I am wondering if you can still have heart problems if an echo is normal? I have had some ecgs, most are normal as well. Is there any other test that are needed to diagnose heart problems?

Thanks!

[Hidden]

With the caveat that I’m not medically qualified, and any answer is just my own personal understanding. The three main, initial tests for most heart conditions that aren’t heart attack or angina related are usually an ecg, an echo, and (depending on the nature of the concern) a holter test, which is effectively a prolonged, ambulatory ecg over anything between 24 hours and 4 weeks. Holters in particular are useful if the issue is arrhythmia or concerns about irregular heart rhythms, in part because arrhythmias may not be caught on spot ecg traces. It can be quite difficult to catch intermittent arrhythmias in the act, so to speak, and until they are, you can’t diagnose them. Outside of those three, the other main tool would be blood tests looking at all the usual markers of a full blood count, and then - depending on what the concerns are - extras like cholesterol, cardiac enzymes (if heart attack was suspected), thyroid, some vitamin and mineral levels, potentially clotting, and maybe BNP if heart failure was a concern. If absolutely everything was normal including the bloods, then as I understand it, that would fairly comprehensively rule out most of the frequently encountered heart issues.

[Heather1957]

I would also say - not a medical person but I would say not.

I don't think it will see blockages inside the heart as an angiogram will.

[deniseinmilden]

I have arrhythmias and had a couple of ablation ops many years ago because I used to have SVT but I don't think I've ever had any problems show up on a standard ECG!

I've had various monitors over the years and only occasionally have the problems been recorded, despite at one point passing out most days.

Last year I was advised by a cardiologist to buy a Kardimobile so I could do my own 6-lead ECGs whenever I want to/have problems and it is absolutely brilliant. I've managed to capture lots of meaningful recordings which are recognised by cardiologists, so much so that they are now taking me seriously and in a couple of weeks I'm going to have a loop monitor fitted which will monitor me for up to 3 years.

[KittyKitten in reply to deniseinmilden]

Is the quality different than fitbit? I just got a fitbit a bit ago and captured pvc's (I think? From my internet research). I read that it was usually harmless so I haven't brought it up to my doctor. Also they only show up randomly since the last 6 months. What kinds of things has the ecg picked up? If you don't mind me asking

[deniseinmilden in reply to KittyKitten]

I'm not sure what the Fitbit is like. The cardiologist just recommended the Kardiamobile so I went for that - it is good!

It will show just about everything any ECG will show.

PVCs and PACs are usually pretty benign and OK, even though they don't feel it! I've had quite a few for decades, no problem.

I also get heart blocks - missed beats - which are fairly OK too. I've had them for decades but I'm getting so many now (sometimes more than 30% dropped beats) that I really struggle to keep going some days. I usually get more ectopics when I'm having a problem but I don't think they are the issue.

Good luck!

[deniseinmilden]

Just seen your post about breathlessness too and I'm exactly the same - if my heart runs well enough that I can tired through doing something, as opposed to just being asleep most of the time with exhaustion. I'd love to know the answer to what causes it. At the moment I'm using cough medicine to ease it a bit but I don't think it's the right thing to do and it isn't long term sustainable.

I have a full complement of nutritional deficiencies but I SI B12 every day and manage to get a whole spectrum of vitamins and minerals into me so I doubt its that...

Except for iron, maybe? I don't seem to be able to convert iron in my diet to haem iron and have to get it from red meat and fish.

Have you tried increasing your red meat and fish intake, especially with vitamin C, and eating it 2 hours away from sources of calcium? (The latter is because calcium locks up iron so it can't be absorbed so you try to keep them separate in your stomach).

Please let me know what you think!

[KittyKitten]

How do you know if your heart is running well enough? Do you have other symptoms?

I inject B12 every 2-3 days right now. A lot of symptoms are gone but I'm left tired/sob/weak, etc. I had anorexia for a long time so I didn't get enough nutrition for a long time, but I get lots now. And I also take supplements too.

My lunch diet for the past month or two, was a plate of bacon and fruit lol. Plus I eat meat nearly every supper, not usually fish, I don't like sea food much. So I don't feel like I am lacking in that area. I also have iron in my supplement. My iron panels have been good the last year or so. My ferritin is the highest it has ever been at 75. I saw one of my old blood tests when it was at 27 many years ago. I never had shortness of breath then.

I feel like it could be damage from malnutrition from being low in nutrients for so long, or maybe I'm missing another nutrient. Or maybe my heart as I had to be on heart meds when I was a baby. Or my lungs because I feel like I can't breathe. Or something else entirely, I really don't know

[deniseinmilden in reply to KittyKitten]

I'm in the same boat as you! My malnutrition has been caused by chronic pancreatitis with a genetic malabsorption problem to compound it but the effects are just the same and I have no idea whether it's just that, issues with my heart or something else (my immune system doesn't work properly either!).

Well done for managing your eating problems - that's superb!

Thank you for your response re iron - that's really helpful to me - as you say, it doesn't sound like that's the problem.

I don't like seafood either but my guts will digest a bit of cod (white fish that isn't too "fishy"!) and it seems to help me. 🙄

Thank you!

[jwd52]

HiI had a double bypass in 2020 but nothing at all had shown up on the ecg's that I had so not sure they show everything.

[Livelovelife56]

Hi My son had a routine echo when he was unwell a couple of years ago. It was clear showed no issues but when his Dad got diagnosed he had repeat echo and ecg and he was found to have HCM. I asked the consultant and she said the tests they do are more specialised and they know what they are looking for which may be missed in routine heart tests. ❤️

[Jetcat]

My echo came back as normal structural and sized heart. X ray ok,Bloods ok. Plumbing ok. But I have had three ablations for paroxysmal Afib, so I would say yes you can have normal echo but still have a problem.?

[Entabeni]

I had a class 2 aviation medical at Castle Donington which included an ECG. Everything was good and I was signed off as fit to fly. Shortly after I suffered a blockage to the left anterior descending artery (the widow maker) and was lucky to survive. Luckily I live 8 minutes away from Leicester’s Glenfield Heart Unit and a paramedic and an ambulance happened to be driving near to our house. 10/10 to my wife’s quick response, the NHS and having 4 stents well within a couple of hours. So much for the aviation medical and ECG as they can’t even guarantee you’ll make the door. Easy revenue for the CAA I guess. Not that this is of much help to you as the ECG just shows a snapshot of how your heart is at that moment. I reckon an echocardiogram draws very much the same conclusion. Anyway, enough waffle, good luck to you, and all the best.