Feel Healthy but Scared

[woodrow555]

I am a 41 years old male, 6 feet tall and 184 pounds.  I run, play basketball, lift weights and am overall very active.  In November of 2008 I had an afib after working all day, drinking coffee, and then having three drinks at dinner.  I woke up in the morning with a fluttering heartbeat, was admitted to my local hospital where they said I have an afib, and was very dehydrated.  I spent the night in the hospital, and my heart converted back to normal rhythm.  A month later I did an echo  (I  was going through an extremely stressful time this week at work as I was losing my job), and the cardiologist said your heart is slightly enlarged on the right side, but not a big worry, there are medications I could take.  He wanted to do one more test, which was a bubble test to see if my heart was communicating properly.   I did the bubble test, the cardiologist who did the test said everything looks very good, not to worry.  At this point I gave up drinking and coffee per my Docs recommendation.  Six months later my hospital writes me a letter and says that they screwed up, that actually the echo from six months ago indicated I had right ventricular systolic dysfunction, right ventricular dilatation, and elevated pulmonary pressure.   I went to see my cardiologist last month, who said I had a very mild case of enlargement, a weak right side of the heart, and mild pulmonary hypertension with a reading of 40-50.  He recommends a right heart cathertization that I can do now or in down the line when I am more comfortable  (he mentioned six months later is OK).  
  Now I have to say before I got that letter I have never felt better.  I work out every day, haven't had a drink of alcohol or caffeine in six months, have lost ten pounds, have a new job and almost no stress.   My question is given the job stress I was under six months ago, could that effect the echo?  Shouldn't I simply get another echo to confirm that perhaps they didn't mistake my records for someone else given the six month timeline?  I have no symptoms of any  kind, ran two miles this morning still feel very good.  Unfortunately I am severely worried about the Pulmonary Hypertension comment, as it appears to be a deadly disease.  Reading the Internet is probably not great, as it scares the hell out of you.  I am constantly concerned and worried about what I should do.  Please help, I am at my wits end, cry a lot, and have three kids under the age of 10 that I love and adore and want to be here for as they get older.

[grendslori]

An angiogram is not the same thing as an echo. An echo isn't going to tell you is you have any blocked arteries. It will show structure issues and bloodflow through the heart chambers. The doctors told you that you have a problem with the right ventricle all along, it seems that they just made light of it. The reason you feel as well as you do is because the left ventricle is the main pumping chamber of the heart. if it goes bad, not enough blood makes it to the brain and other parts of the body.....you feel miserable, can't breathe normally, are dizzy all the time etc. The right ventricle is the 'return' chamber for the heart. The problems you will have is with blood pooling in the lower parts of your body, ankles and legs will be swollen. If you are scared, have another echo done and see what that shows.

[woodrow555]

Thank you very much for the note, it makes me feel a lot better.   I have been so stressed about this that I have a hard time thinking about anything else.  My plan is to get another echo in a few months as I measure my overall health and then potentially proceed with the angiogram if that's what's recommended.  Thank you for the kind words.

[Encephalomalcia]

Ask the doctor if he or she can order another echocardiogram for you at least for some piece of mind.  The echocardiogram is just one tool to use and sometimes is not that accurate.  The most accurate procedure to have done is the angiogram.  The angiogram can measure the pressure in your heart and check for blockage in the arteries.  Medications can be taken for the pulmonary pressure and cholesterol.  If you have significant blockage in the right artery, you may want to think it over about having a stent put in to hold the artery open.  When blockage is in the arteries for a number of years, it becomes extremely hard and then it is really difficult to put a stent in without tearing the artery that has become weak.  Hopefully, the next echocardiogram will bring positive results and you may only have to take medication.  Keep your stress level down and take care.