Interventional Cardiology Expert Forum
More tests and Septum Question
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Questions in the Interventional Cardiology forum are answered by medical professionals affiliated with the Truman Medical Center. Topics covered include acute coronary syndrome, angina , atrial fibrillation , cardiac catheterization , cardiomyopathy , drug abuse & cardiac disease, echocardiography , heart failure , hypertension & heart disease , lipid management , minorities and heart disease, peripheral vascular disease prevention, valvular heart disease , women’s heart health, and the warning signs of a heart attack.

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More tests and Septum Question

In January of 2006 I had a fluttery feeling in my chest and thought it prudent to contact a Cardiologist.  I have been diagnosed with a right bundle branch blockage previously and a Cardiologist friend years back explained I had a "thick" heart and again was given no subsequent instructions. I went to see the Dr. (the Chief of Cardiology) BP was 120/70 and did a complete blood and physical exam.  I was then asked to wear a Holter monitor for 24 hours, do a stress thallium test, EKG, as well as an echo cardiogram.  After the first we were told it was Hypertrophic Cardiomyopathy.  He then asked the assistant and a second practitioner to do a second echo. After the test he saw me and said "good news” he explained that this was located at "a different portion of the heart" and all I had was a thickening of the septum.  He later prescribed Toprol XL and I have been on it for two years now with little or no issues. I decided to go back asking if I might wean off the Toprol XL.  I brought along my most recent blood work and EKG - all were good.  BP was 110/80. The Dr. said that since I had an EKG recently he would not do one.  He said, "I am not going to make more of this than there is."  He then added that he wants me to wear the Holter monitor for a day and do another echo and to see him “in a month for the results.” Dr.'s why would he ask for this?  Isn't there a good chance that if my echo's were OK previously they will still remain that way, especially in light of the Toprol use?  I am seriously nervous about what might happen and in looking up (the worst thing I could do) Hypertrophic Cardiomyopathy.  I have imagined my septum situation turning into this illness and all the possible routes it could traverse. I am embarrassed to say it but people like me are somewhat less equipped to handle the fear this causes.  Please offer me some information and expertise.  I truly appreciate your time and consideration.
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I am not clear on what the abnormality was that you have but you should be retested to make sure there has been no progression of the process.  Hypertrophic cardiomyopathy can effect various parts of the heart and this is something that needs to be monitored.
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Dr. Bogart,

I spoke with him today and it would seem that it is HCM but that the location of the "thickness" is not as pressing as he thought.  Also after the echo today he stated that the "gradient" was the same from two years ago and everything was "good."  I guess this is a positive thing.  When I asked him if I should be concerned he simply said that this needs to be monitored annually.  Is it your experience that with Toprol XL and proper diet and the like, this situation is able to be treated effectively without surgical intervention?  Please advise as I could use some reassurance.
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