I'm frustrated

[Oregon]

Thank You for awnsering my question. A year ago a doctor told me I had a heart murmur.  The echo report from the cardiologist says "The LV is not dialated.  There is mild hypokinesia at the LV base, otherwise normal function.  No LVH present  The MV leaflet shows redundant tissue and ther is marked mid-late systolic prolapse of both leaflets trivial mild MR in late systole.

AO     32
LA     34
IVS    10
LV(d)  52
LV(s)  34
PW     11
FS     34%
EF     59%

My new cardiologist (we have moved) said he doesn't care what the previous doctor said he doesn't think the degree of regurgitation has changed much.  I can't read all of the writing on my most current echo report but it says mildly dialated LV, preserved LV systolic function.  Anterior and posterior prolapse with moderate eccentric posteriorly directed MR.  

AO     29
LA     29
LV(d)  55
LV(s)  40
sw      7
pw      7
mitral valve regurgitation moderate/severe
EF      55%

I am not sure what questions I should ask at my next appointment.  He doesn't think the regurgitation has really changed as much as is reported but rather the first cardiologist underestimated it.  I just want to take charge and ask the right questions.  I know not much has changed other than the degree of regurgitation. We move frequently so I learned a long time ago that I have to take charge of my own medical care.  Unfortunately this doctor doesn't say much and it is very hard to ask him questions. I am most concerned about the LV hypokinesia, increase in regurgiation, and LV dialation.  Thank You very much for your time.

[CCF-M.D.-MJM]

Hi Oregon,

I think what your cardiologist is trying to say is that despite the difference in your report, he doesn't think anything has changed.  From looking at the numbers, they all look they would be within standard operator error (ie there is not much difference between an EF of 59% and 55% and a LV(s) of 34 and 40.  You could probably average the two numbers and be reasonably correct.

Obtaining a copy of your most recent studies and taking them with you is probably what is most important.  The most accurate way to compare studies is to look at them side by side (VHS or on CD)--the written report is of little use.  Obtaining the VHS or CD and having your doctor compare to previous years is probably the best way to take control of your health care.

I think you are appropriately following your MVP with serial exams.  If subtle differences appear, they will be most evident by comparing previous year studies.  I am not sure the significance of the LV hypokinesis, increase in regurgitation, and LV dilation.  These are subtle findings subject to inter-operator variability.  Serial exams will tease out these differnces.

I hope this answers your questions.

Good luck.

[Gaspipe]

Good questions... a suggestion next time you post include info about yourself ie age, gender, pertinant medical and health history, reasons for the test, symptoms etc. It gives the doc a chance to put your test results in perspective.

[Oregon]

Sorry, I am female, 38yo.  My doctor found the murmur during a routine exam last year.  Then it was very hard to hear.  Now any doctor I see hears it immediately without looking at my records.  I didn't have any PVC's or anything noted on an ecg until September and now I have lots of PVC's and during the cooldown from a stress test I had problems with Ventricular Tachycardia.

[Mike051573]

  Talk about being "frustrated" myself,here I am finally posting a comment to this website.Ive been coming here reading everyones posts from time to time over the last I dont know how many years.I suffer from what I believe are either PVC's or I dont even know what,and everytime I get to the ER room (thinking I am about to either die or,etc..),every doctor says "theres nothing" wrong when having me on an EKG/etc..when as I sit here trying to figure this all out,and what/why every other doctor says the same thing then tell me that its anxiety/not eating right/etc.. and I am afraid to do entirely almost ANY physical activity that I once used to do...(im starting to go on and on so ill stop),yet I wanted to say that I can relate to what you are saying.
  Ive been trying to post on this site for a few years yet im also looking for some "fellowship" out there with all this I love this website and my email address is: ***@****

- Mike (the PVC king)

[arthur]

If you've been reading these posts for years, then you know that PVC/PACs and other assorted short-duration arrhythmias or often touted as "benign" as long as you have a structurally normal heart.  When a cardio tells you that, and you have your doubts, seek a second or third opinion.  If they all they all tell you that, then there's a separate issue afoot...something most folks will tell you is anxiety-related.

The one thing you can conclude for sure is that PVCs and PACs definitely are disquieting and prompt one to get on edge, mostly because one feels that "there must be a reason" for these things to occur.  That's about where the anxiety wheel begins.  It inevitably leads to an incessant quest for an answer and an insatiable hope for a "cure".  At the very least, it leads to an unquenchable need for reassurance, which feels good while it's being received, but wears off in no time.

For me, being a scientist, the anxiety cure came by means of understanding.  Discussions with no less than five local cardio/EPs, several research EPs, and searching through the medical literature including reading the "arrhythmia" sections of medical text books, eventually gave me peace of mind.  In spite of what many in this forum claim, there are answers out there that explain why PVCs/PACs occur.  It's not a mystery, at least for most cases.  That worked for me...for someone else it could be as simple as trusting their doctor.  

I wish you well in your quest for peace of mind.  You might ask yourself, "how often do I check my pulse?"  ... if you have an answer, then you may have a problem.

-Arthur

[Barbarella]

But what if a Cardiologist tells you that getting PVC's while exercising "is nothing to worry about" yet you read on the Internet stuff posted by the medical profession/Cardiologists that PVC's CAN kill you while exercising?  We have an HMO insurance and we are only allowed so many visits to a Specialist in a certain amount of time.  We cannot go from doctor to doctor.  They tell us WHO to see.  I went for a second opinion and he said "your cardio was right what he said", when I mentioned what I read on the Internet I was told "don't believe anything what you read on the Internet".  So I ask myself who is right?  The Cardiologists who I saw or the stuff on the Internet which is also posted by Cardiologists from different teaching hospitals etc.  I get PVC's frequently while exercising and all I was told was "it hasn't killed you yet has it?"

Its the doctors who have different opinions what confuses us.  Same goes for side effects of meds.  Most of them are not fully informed about certain side effects and deny them yet they are printed on the inserts of the meds, you can bring along the inserts for your appointment and some of these doctors still brush it off and insist that you keep on taking the same meds or give you new meds to take care of the side effect/effects of the current meds you are taking.

[Gaspipe]

I read your posts and it seems to me you are always looking for the perfect solution or single answer. Medicine is a very inexact science and there are no single or perfect answers. As far as PVC's go if you have not figured it out by now there is no perfect treatment for them..period. So do want a doctor to tell you are going to drop dead while excercsing? If you keep searching every internet source you will eventually find something to back this up. Otherwise trust in your doctor or before you know it you'll be old and gray and I hate to say it to you but 50 years from now most of us will not still be posting!! As far as yor obcession with the side effects of meds I hate to break it to you but no medicine exists without side effects especially with long term use. Meds are all about risks vs. benefits and you and your doc decide on this type of thing. I don't mean to sound harsh and I wish to be supportive but you've got to realize perfection does not exist on this earth.

[StephPT]

Well put.  The difference between medicine and poison is only the dose.

[tickertock]

that's what i call hitting the nail on head, dead center at that, great post.

[Barbarella]

Hey gaspipe,

I've been having PVC's for the last 40yrs and am still kicking, I know there is no perfect answer for them.  And NO I'm not searching the Internet to find answers about them.  Isn't this site the "Internet"??, aren't you all on the Internet searching for answers?? or exchanging your experiences with certain heart related issues??  Matter of fact I read on this very site about a year ago somebody telling me when I said that "my cardiologist told me not to worry about PVC's during exercise" somebody on this very site said to me "you better worry about it or your next exercise might be your last" I don't remember the exact words but it was close to it.  I don't remember the name of the person, but if the site administrators were to go back I bet they would find it.  

As for side effects I'm very lucky that I don't have any except for one.  I never had high Cholesterol until I was put on a water pill (Lasix) no diet changes and no life style changes and my cholesterol shut from 204 to 302 in 7 months.  One of the side effects listed for Lasix is a possible rise in cholesterol and glucose levels.  When mentioning this to my doctor he denied it even though I showed him this listed side effect.  All I asked for to maybe be switched to another water pill to see if the cholesterol will go down, but he insisted I keep on taking it AND put me on Zocor.  Sorry, call me a perfectionist, so be it.  It is my body, and my side effect I at least have the right to ask if I can be switched to another pill.  I'm sure every one of you on this board who are cheering you on and are bashing me would probably have done the same if your cholesterol had shut up 100 points with no diet or life style changes or major stress in that short period of time.

My husband was on a BP pill (calcium channel blocker) and it almost killed him.  He practically begged his doctor to switch him to another BP pill, he developed a blood disorder and had to see a Hematologist who took him off this BP pill IMMEDIATELY and switched him to another one and he has been fine ever since.  Maybe I didn't make myself clear.  All I meant was when a patient thinks he or she has a side effect, and I mean a serious side effect why not switch the patient to another pill to see if the situation will get better. Why insist on ignoring the patient and insist on taking that medication?  Sure all meds have side effects and everybody is different, but there is more than one meds out there why not switch and see what happens?  That is all I was saying.    

[Barbarella]

I forgot to mention this about the cholesterol.  I'm not a doctor nor am I scientist and I may be totally wrong about this but this is my opinion.  As I mentioned in my previous post above my cholesterol started to rise once I took the Lasix.  Three months after taking Lasix I went from TC 204 to 240, four months later I was at 302, WITHOUT ANY LIFE STYLE OR DIET CHANGES or major stress.  On 1/14 I was put on 20mg of Zocor.  On 2/16 my TC has dropped to 209 from 302 and this in ONE MONTH (tested at a hospital).  I know several people who took 40mg of Zocor and had to take another drug "Zetia" on top of the Zocor after three months of taking the Zocor because their doctor was not satisfied.  My opinion, and again I may be totally wrong about this, in my case the Zocor only had to deal with the Lasix pill and not with junk food, fast food, no exercise etc.  All the people I talked to none of them had a drop of 100 points in their cholesterol in only one month of taking only 20mg or even more.

But like I said before switching to another water pill or maybe even eliminating it probably would've dropped my cholesterol too, but I was not brave enough to try it on my own, I kept on following my doctor's orders.

[Barbarella]

The 20mg of Zocor I took "every other evening" for only one month NOT "every evening" as I was told.

[MaryRoe]

I was at cardiac rehab in the low risk group for a future event and there was another lady with me in the low risk goup.  Both of us were being monitored.  She started to have what she said were palpiations/fast heart rate and then she was gone.

I take allllllll Palpitations seriously....