please help im scared, recieved this letter :(

Furthur to previous corrospondence, miss watson has now had an echocardiogram, the study was a bit difficult as Nichola was noticed to be very anxious with marked sinus tachycardia of between 11- and 130 beats per minute.

As such both her left and right ventricular function does appear mildly inpaired, although this is difficult to asses accurately in such tachycardic state, I am a bit hesitant to suggest a clear cut abnormality here but i think that we should check this out with some furthur study, as such i would be grateful if you could organise a blood test for BNP, as a clearly evevated value would suggest a myocardial problem but equally a normal value would be reassuring here.

I would be very happy to see her in clinic and discuss all this with her personally and having that result would make the situation that much more easier to interpret. i will organise a routine outpatient appointment for her accordingly and we can take matters from there.

oh no! what do this mean?

34 Replies

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  • I want to answer your question, as I can see how scared you are, but dont know how to as I dont have the knowledge.

    What symptoms led you to have the echocardigram in the first place? and how long have you been having these?

    Moggie x

  • i suffer with palpatations, anxiety, i have a thyroid nodule have sooo many symptoms of hyper and hypo x

  • I don't have any answers honey, but I also have palpations and a goitre nodule, and I had signs of hyper and hypo at the same time. I started on NDT 22 days ago and started taking my beta blocker in the evening and that helped with the palps. They are sorta scary but I,have had mine all my life. Good luck. Don't be scared. X x

  • yes the answers to moggie's questions will help.

    It doesn't seem too serious as they want to see you with a 'routine' outpatient appointment.

    I have a friend who is very knowleadgeable about these things so I can ask him tonight :)

  • That's really sweet of you NBD.

    Moggie x

  • Thank you, im wondering is thyroid disease is a key to this, im so scared x

  • my friend who is a cardiac physiologist said that it is often normal not to be able to visualise things if the heart is beating too fast, so in essence this person writing the letter is just saying that.....

    he said they can slow down the recording of your echo but the slow playback is often of very poor quality and they cannot see things properly still....but another way (and safe way) to do it is to do another echo and give you some 'beta blocker' type of medication before the echo to slow down your heart rate then they can see properly.

    The blood test mentioned in the letter is a 'marker' for a 'damaged' heart (lay term), if it is raised there is a cause of suspicion and they'd need to do further tests.

    At this stage I wouldn't worry as they just could not visualise things properly and that is that, wait unti you have had the blood test and maybe another echo with beta-blocker meds.

    My friend also said that it is VERY VERY common for people's heart rates to be high during these tests out of them being 'worried', is your heart rate often fast or was it only during this scan?

    PS I don't have any evidence to say if it is thyroid related or not and also at this stage we don't even know 'if' there is anything wrong 'yet'

  • My heart races alot due to anxiety levels, and i was out of my comfort zone so to speak, i also get palpatations, thanks for your reply and getting help from someone else!

    i know thyroid problems can link to cardiac problems this is why im asking.

    So maybe everything is ok then? x

  • yes, hopefully, keep us posted once you have had the other tests and your outpatient appointment x

  • I will do, thanks very much x

  • In my opinion (though I am no expert at medical-ese by any means).... this seems to say that the ECG test that you had done reported 'tachycardia' (which simply means an elevated heart rate). They appear to be saying that you appeared anxious at the test - and that that could be the reason for the elevated heart rate. But that, rather than just write it off as being just your anxiousness, they want to do further tests to make sure there isn't an underlying problem.

  • The letter suggests that "left and right ventricular function does appear mildly impaired" could likely be due to the elevated heart rate.

  • can thyroid problem cause this? x

  • Anxiety certainly can, but I have PM-ed you reassuringly with own experience many years ago.

  • Hi Was the study a home monitor? Was it for 24 hours or 7 days? It sounds to me like AF but without an episode on tape, it is very intermittent at first. If it was not a home monitor then you need one, nothing else except pulse will show AF., unless very lucky,There is of course, a connection with the thyroid, have you had TSH, T4 and Free T3 tested? you need them all for a diagnosis. Is the specialist a specialist arrythmia cardio ( large hospital) as needs to be?.I would start by doing your pulse( HR) at least three times a day,including when having symptoms. See the cardio again if you cannot go elsewhere but take your readings with you. Like everything lots of bad cardios, I had 6 before the correct treatment., and some of them had not a clue! Worse than most of the consultants as they all think they are God! is it swinging some of the time?In the mean time, try not to worry, not too serious but does need sorting.

    Best wishes,

    Jackie

  • No hun it was a heart scan, they are doing a bnp blood test tuesday, i do sometimes get fast heart rate, it always got put down to my anxiety, i am fighting for a diagnosis on thyroid problems, i had a tsh level of 1.73, serum t3 5.0 and serum t4 11.0 this february, i have since gave up smoking 8 weeks ago and symptoms are alot worse, i seem to suffer with both hyper and hypo symptoms, i also have a thyroid nodule, suffered with anxiety for 18 years, swallowing problems, alot of symptoms of a thyroid problem also, can i ask what AF is please? x

  • what cause your bad cardio's was it thyroid related? x

  • Hi Nichola, My heart very complicated so I doubt it. However a Prof of endocrinology said that thyroid disease can bring on the onset of Atrial Fibrillation,(to a friend) ie it would have started eventually any way. There is certainly a strong relationship. I have very serious heart problems and end stage cardiac failure but I see a good endo ( that is important) and although my thyroid( hashi ) is very stable ,I have thyroid tests every 2 to 6 weeks because of the connection with that and my other co morbidities. Even one of the useless cardios told me essential to see only a cardiologist for thyroid disease.( I was seeing a private doctor) I am lucky as my endo is brilliant in every way.

    I stress, AF is not serious, intermitten, often always, can get worse.So, very hard to diagnose without the procedures I have stated. However, there are drugs and if a lot worse procedures for "normal "people The vital thing is to have the correct tests and be on anticoagulation, what ever age for life The risks is usually of clots generally strokes, can be heart..Sorry it is a well known abbreviation ( and I like short cuts) AF is atrial Fibrillation and it is the Atria ,2 top chambers in the heart not transmitting correctly.There are 4 chambers, bottom 2 are Ventricals, far more important. You must ask for the correct test and I would definitely see an Arrythmia or electrical cardio, often the same thing.. You need the home monitor to be analysed ,it does tiny non stop ECG`s, unique.It sounds exactly like AF to me, very common.,but still needs Warfarin etc.There are laso drugs to make you feel better, Betablockers to start with usually, they must never be taken before a thyroid test, false result.The other thing is make sure your electrolytes are all in range, blood test. Magnesium, calcium ( repeats if taking vit D,every 3 months ,vital) , U`s and E`s ( kidney function) ,especially Potassium, should ideally be around 4 and sodium, must all be in range ( effects the BP but more important for heart)Repeat tests every 3 months.If you end up on Amioderone, very good, horrible side effects but last resort drug, you will need more thyroid drugs.It takes up to 6 months in the body for the full effect, starting or ending taking it.

    I hope that is clear, I am dyslexic and complicated subject. If not get back to me, I do not mind being asked to explain it!

    Best wishes,

    Jackie

  • PS I have nodules and swollen thyroid ( hashi) but immaterial for heart . Often upper gut problems are heart, no one not even docs on themselves can tell the difference, so, it may improve with the correct drugs.

    Jackie

  • i had my pottasium level dont with full blood count last august 2012 i have results here if you would like any, in regards to my letter and it being the left and right do this mean it sounds very much if a problem for it to be AF? sorry ive been freaking out since ive had the letter, do these kind of problems arise with thyroid disturbances? im almost certain because ive gave up smoking 8 weeks ago maybe my blood results will be different now as ive heard smoking helps the metabolisum and can mask thyroid problems, although i was getting thyroid (hyper/hypo) symptoms i have seemed to of gotten more ill since giving up the ciggies :/ x

  • hi I doubt it is related to smoking. If i is the ventricals then then it is something simllar but more serious if it was or she suspected that I think that she would have followed it up in greater detail and probably discussed a procedure with you Even this requires a home monitor. All the 4 main electrolytes are vital and if taking vit d make sure your calcium is in range and repeat monthly ideally. Electrolytes out of range can do this. I would go back and ask for a specific referral and first a home monitor. She should not have left this ,even if very old. Potassium must be about 4, very important and varies every day ,so as many tests as possible. Normally U`s and E`s.They need checking anyway for your kidney function. It is the GFR that matters for kidney and should ideally be above 50 or higher if pos. no ranges for GFR.

    Jackie

  • my pottasuim in august 2012 was 3.5 do this give you any help?

    serum calcuim 2.53 no ranges, do mine seem as though it is linking to AF possible thyroid problem? x

  • Hi Potassium on the ow side, probably just in range but ranges vary. It does need to be a we bit higher. Action, a U`s and E`s test, it would be dangerous to have potassium any lower to the heart. You need a magnesium test as this especially effects Potassium, very small range. You may need to eat more food with magnesium in to help the potassium but tests vital.The calcium, it is the corrected result that matters, if only one it will be that range is 2.2 to 2,.6,so OK but needs watching, say 3 monthly unless on D then, monthly Any heart problem may be influenced by thyroid. Make sure your TSH, FT3 and T4 are right for you. but now you have had a cardiac problem seen, it must be sorted regardless of any other disease.I have also noticed, with VT`s very high BP at that ti, even though heart rate high.With AF BP often goes low when HR high, never heard it officially. My cardio shares my opinion of cardios and says I do have to know more than them otherwise when I go into hospital with emergencies can be fatal for me!

    If you want to ask further, fine but it will be Fri AM before I can reply as complicated afternoo and then nephrologist, then exhausted!!

    Jackie

  • aww you seem to be going through it!

    Ive just ordered up to date t4, tsh, ft4, ft3 and the 2 antibodies test from blue horizon, i will let you know of the outcome! x

  • Hi Hoe just have a quick check on PC. Well done ,so important.I think well worth the cost, cost so much more for the same tests at a private hospital and so easy.

    Let me know.

    Jackie

  • will do hun, last test i had for just the tsh, serum t3 and serum t4 was in february, so may have changed x

  • *done

  • Hi Nichola, I had this test done in October. My heart rate was 100, no different to how it was all the time. It did show some leaking valves, But getting back to the palps mine improved a lot on much higher doses of Levothyroxine. Dr S said my heart disease will get much worse if we don't find a treatment for hypothyroidism that works for me. Before the rise in Levo my heart used to pound so much my body used to shake. Often in the night I would get woken by this and it was very frightening. I honestly thought I was going to have a heart attack.

    Dr S said my heart had such a high rate because my thyroxine level was very low and my heart was tring to pump what little there was to vital organs.

    Good luck with everything. X

  • What test the bnp?

    I haven't had a diagnosis as yet, its driving me nuts, the can clearly see i have alot going on and still think im "mental", im hoping to bring this all up with the cardiologist and he listens, there is a strong link with thyroid and heart isn't there?

    Do you think it was your thyroid that caused this with your heart and is it true with the right medication for thyroid it can reverse the effects on your heart?

    Im really scared they are going to find something they can't treat :( x

  • my t4 was actually low in range and i just read a article about low t4 causing low levels of thyroxine am i right? x

  • It is very worrying and I can understand why you are so distressed. Yes there is a strong link, some people get enlarged hearts when hypo. This seems to resolve on optimal meds.

    If your FT4 is very low you need more Levothyroxine to up your levels. Nothing in your body will function well if your thyroxine is too low.

    I hope you get what you need and improve quickly. XX

  • Thanks, im not on any meds as yet, still trying to get them to listen to me, maybe now this has happened with my heart they might realise after all it is my thyroid! x

  • OMG I thought maybe you were just on too low a dose. You have to fight to get treated, so unfair when you feel terrible.

    Hugs,

    Helen. XX

  • I am battling a fight but i will do this, fed up with getting all these diagnosing that clearly links to my thyroid, i also have a thyroid nodule, they wont even try out the meds x

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