BNP and echo results and malnutrition test - Help

[daizy2]

Echo showed possible cardiomyopathy. Also possible heart flutter shown on reveal device. Why possible and no firm diagnosis?

Requested a BNP test. The result was high at 330 pg/mL. The nurse contacted my cardio who was on hols. He recommended that an echo be performed on that day. Results discussed two days later. Cardio said that the BNP at 335 was suggestive of heart failure. Again why not a firm diagnosis of HF?

Echo showed left ventricle to be mildly dilated, borderline septal hypokinesis. (I understand this part).

Trace mitral regurgitation and trace trcuspid regurgiation. Aortic valve is trileaflet. What does this mean?

He mentioned tests were subjective and that I needed to have an angio done. I said I felt too ill (I have Lyme borreliosis and this is causing very nasty symptoms) and chose instead ot have a 64 slice 3D angioscan.

Echo and the BNP tests should be sufficient for diagnosis of HF? Why doing the angiogram or the 64 slice 3 D scan?

Finally, my diet is seriously depleted.  some tests have revealed some defficiencies, but are there any tests that can be done to show malnutrition which could have in fact triggered the heart failure?  

I have to budget and be selective on which tests I should have. He has referred me to the NHS hospital in the past whenever I have not been able to afford procedures or meds.

thanks for sharing info.
kooky

[ddavey]

there is the possiblity that anemia can cause cardiomyopathy, so you need to have your iron levels checked immediately.  have they started you on any medications, and did they say or do you know what your ejection fraction was from the echo?  i don't understand why that particular testing is being recommended for a diagnosis, initially an echo can give that diagnosis and meds are usually started immediately at that point (at low doses)    unless they saw something in the echo that is there and may the reason for your bnp to increase and the left ventricle to be mildly dilated (there are sometimes reasons for these findings which if corrected will improve the other issues)  hope everything goes well        ddavey

[daizy2]

Well, will have iron checked.  For the last 5 years, bad allergies to many foods, only able to eat about 5 foods.  This is why I am suffering form nutritional deficiencies.

In any case, now it seems it has developed to heart failure.  I can't understand why the cardio is not more specific.  Cardio said it COULD BE HEART FAILURE.  Is it or is it not heart failure?  

BNP is raised to 335 and echo showed showed left ventricle to be mildly dilated, borderline septal hypokinesis. (I understand this part). + breathlessness, fluid retention etc...EF was 51%.  but I felt as if I was dying so weak and so ill.

Trace mitral regurgitation and trace trcuspid regurgiation. Aortic valve is trileaflet. What does this mean?

I was not started on any meds.  No advice.  Just will have the angioscan not angiogram on Monday.  Had a thyroid test done this am.

Which questions should I ask the cardiologist the next time I see him?

Many thanks
Daizy2

from ddavey
there is the possiblity that anemia can cause cardiomyopathy, so you need to have your iron levels checked immediately. have they started you on any medications, and did they say or do you know what your ejection fraction was from the echo? i don't understand why that particular testing is being recommended for a diagnosis, initially an echo can give that diagnosis and meds are usually started immediately at that point (at low doses) unless they saw something in the echo that is there and may the reason for your bnp to increase and the left ventricle to be mildly dilated (there are sometimes reasons for these findings which if corrected will improve the other issues) hope everything goes well ddavey

[anacyde]

Severe nutritional deficiencies can lead to or aggravate cardiomyopathy, or it could be secondary to another condition you have.  Anemina, as mentioned by others, can do it.  I would think the BNP and echo would be enough for a diagnosis, however, nuclear studies ARE more definitive.  The BNP is not suggestive, it is definitive.  There's definitely a problem, it's just a matter of defining exactly what and why.  Have you been given medications for this?  Typically and ACE-I at least would be necessary.

[anacyde]

Severe nutritional deficiencies can lead to or aggravate cardiomyopathy, or it could be secondary to another condition you have.  Anemina, as mentioned by others, can do it.  I would think the BNP and echo would be enough for a diagnosis, however, nuclear studies ARE more definitive.  The BNP is not suggestive, it is definitive.  There's definitely a problem, it's just a matter of defining exactly what and why.  Have you been given medications for this?  Typically and ACE-I at least would be necessary.

[ddavey]

i don't understand why meds were not given to you, and that should be the first thing to ask your doctor.  as mentioned, an ace inhibitor (ex. enalapril) and a beta blocker (ex coreg)  are usually the first standard drugs given  i would definately push for why no drugs were given, especially if you feel breathless and have fluid retention         just a note also, if you get placed on coreg, please make sure you have your iron levels checked first,   coreg side effects at initial start, can be fainting, but that is also an issue with anemia (my daughter had a couple fainting spells when starting coreg, but it was actually anemia)  there is a possiblity that the angiscan may find out what is causing your problems, and cardiomyopathy may be secondary to something else that can be taken care of.   best wishes to you

[daizy2]

Cardiologist said that there is a need to find out what is causing heart failure before taking drugs.  He said if it was because of cardiac disease it would be different if it was caused by chronic lyme borrelliosis infection from which I suffer from.  But in anycase, I am not having an angiogram at this point, I am too unwell, have to chosen the 64 3D scan instead.  This will be performed on Monday.  Meanwhile, I have been prescribed steroids to take on Sunday and Monday am in case I react to the Iodine.  I am very worried about this all.
Thanks for all the good wishes.

Daizy